ILLINOIS REGISTER 15127 10 DEPARTMENT OF PUBLIC ...

ILLINOIS REGISTER 15127 10

DEPARTMENT OF PUBLIC HEALTH

NOTICE OF PROPOSED AMENDMENTS

1) Heading of the Part: Hospital Licensing Requirements 2) Code Citation: 77 Ill. Adm. Code 250 3) Section Numbers: Proposed Action:

250.160 Amend 250.1910 Amend 250.1980 Amend 250.2450 Amend

250.2460 Amend 250.2470 Amend 250.2480 Amend 250.2490 Amend 250.2500 Amend 250.2610 Amend 250.2620 Amend 250.2630 Amend 250.2640 Amend 250.2650 Amend 250.2660 Amend 250.2670 Amend 250.2680 Amend 4) Statutory Authority: Hospital Licensing Act [210 ILCS 85] 5) A Complete Description of the Subjects and Issues Involved: This Part establishes

minimum standards for hospitals in Illinois, including design and construction standards for new hospitals and minimum construction standards for existing hospitals.

This proposed rulemaking amends two Sections in Subpart P, the six construction Sections in Subpart T, and all eight Sections in Subpart U. These Sections contain references to National Fire Protection Association building and life-safety codes, and other design standards, listed in Section 250.160 (Incorporated and Referenced Materials) in this Part. While that Section was brought up to date with comprehensive amendments in the spring of 2008, the citations in the corresponding construction Sections were not changed. Some of these Sections have not been amended or updated since the 1980s, making for huge discrepancies between them and Section 250.160, and with current construction standards.




In each Section being amended, the dates of the NFPA Standards are being stricken, meaning that as new NFPA Standards are published in the future, the Department will have to amend only Section 250.160. Additionally, numerous technical, grammatical, and form changes are being made to bring the rules into conformity with current Secretary of State style requirements. Section 250.160 is being amended to add the Private Sewage Disposal Code (77 Ill. Adm. Code 905).

Additionally, statutory language from Public Act 96-0925, which requires hospitals to have policies for gaining access to locked bathroom doors, is being added to Section 250.2450 (Details).

The economic effect of this proposed rulemaking is unknown. Therefore, the Department requests any information that would assist in calculating this effect.

The Department anticipates adoption of this rulemaking approximately six to nine months after publication of the Notice in the Illinois Register.

6) Published studies or reports, and sources of underlying data, used to compose this

rulemaking: None 7) Will this rulemaking replace any emergency rulemaking currently in effect? No 8) Does this rulemaking contain an automatic repeal date? No 9) Does this rulemaking contain incorporations by reference? No 10) Are there any other proposed rulemakings pending on this Part? Yes

Section Numbers: Proposed Action: Illinois Register Citation: 250.285 New June 11, 2010; 34 Ill. Reg. 7858

250.290 New June 11, 2010; 34 Ill. Reg. 7858 250.1090 Amend June 11, 2010; 34 Ill. Reg. 7858 250.1300 Amend June 11, 2010; 34 Ill. Reg. 7858 250.1305 Amend June 11, 2010; 34 Ill. Reg. 7858 250.1830 Amend June 11, 2010; 34 Ill. Reg. 7858 250.310 Amend June 18, 2010; 34 Ill. Reg. 8005 250.330 Amend June 18, 2010; 34 Ill. Reg. 8005 250.130 Amend October 8, 2010; 34 Ill. Reg. 250.260 Amend October 8, 2010; 34 Ill. Reg.




250.1030 Amend October 8, 2010; 34 Ill. Reg. 250.1230 Amend October 8, 2010; 34 Ill. Reg.

11) Statement of Statewide Policy Objectives: This rulemaking may create a State mandate

under the State Mandates Act [30 ILCS 805]. 12) Time, Place, and Manner in which interested persons may comment on this proposed

rulemaking: Interested persons may present their comments concerning this rulemaking within 45 days after this issue of the Illinois Register to:

Susan Meister Division of Legal Services Illinois Department of Public Health 535 West Jefferson St., 5th Floor Springfield, Illinois 62761 217/782-2043 e-mail: [email protected]

13) Initial Regulatory Flexibility Analysis:

A) Type of small businesses, small municipalities and not-for-profit corporations affected: Hospitals

B) Reporting, bookkeeping or other procedures required for compliance: None

C) Types of professional skills necessary for compliance: None

14) Regulatory Agenda on which this rulemaking was summarized: This rulemaking was not

included on either of the two most recent Regulatory Agendas because: the need for the rulemaking was not known when the last two regulatory agendas were drafted.

The full text of the Proposed Amendments begins on the next page:




TITLE 77: PUBLIC HEALTH CHAPTER I: DEPARTMENT OF PUBLIC HEALTH

SUBCHAPTER b: HOSPITALS AND AMBULATORY CARE FACILITIES

PART 250 HOSPITAL LICENSING REQUIREMENTS

SUBPART A: GENERAL

Section 250.110 Application for and Issuance of Permit to Establish a Hospital 250.120 Application for and Issuance of a License to Operate a Hospital 250.130 Administration by the Department 250.140 Hearings 250.150 Definitions 250.160 Incorporated and Referenced Materials

SUBPART B: ADMINISTRATION AND PLANNING

Section 250.210 The Governing Board 250.220 Accounting 250.230 Planning 250.240 Admission and Discharge 250.250 Visiting Rules 250.260 Patients' Rights 250.265 Language Assistance Services 250.270 Manuals of Procedure 250.280 Agreement with Designated Organ Procurement Agencies

SUBPART C: THE MEDICAL STAFF

Section 250.310 Organization 250.315 House Staff Members 250.320 Admission and Supervision of Patients 250.330 Orders for Medications and Treatments 250.340 Availability for Emergencies




SUBPART D: PERSONNEL SERVICE

Section 250.410 Organization 250.420 Personnel Records 250.430 Duty Assignments 250.435 Health Care Worker Background Check 250.440 Education Programs 250.450 Personnel Health Requirements 250.460 Benefits

SUBPART E: LABORATORY

Section 250.510 Laboratory Services 250.520 Blood and Blood Components 250.525 Designated Blood Donor Program 250.530 Proficiency Survey Program (Repealed) 250.540 Laboratory Personnel (Repealed) 250.550 Western Blot Assay Testing Procedures (Repealed)

SUBPART F: RADIOLOGICAL SERVICES

Section 250.610 General Diagnostic Procedures and Treatments 250.620 Radioactive Isotopes 250.630 General Policies and Procedures Manual

SUBPART G: GENERAL HOSPITAL EMERGENCY SERVICE

Section 250.710 Classification of Emergency Services 250.720 General Requirements 250.725 Notification of Emergency Personnel 250.730 Community or Areawide Planning 250.740 Disaster and Mass Casualty Program 250.750 Emergency Services for Sexual Assault Victims

SUBPART H: RESTORATIVE AND REHABILITATION SERVICES




Section 250.810 Applicability of Other Parts of These Requirements 250.820 General 250.830 Classifications of Restorative and Rehabilitation Services 250.840 General Requirements for all Classifications 250.850 Specific Requirements for Comprehensive Physical Rehabilitation Services 250.860 Medical Direction 250.870 Nursing Care 250.880 Additional Allied Health Services 250.890 Animal-Assisted Therapy

SUBPART I: NURSING SERVICE AND ADMINISTRATION

Section 250.910 Nursing Services 250.920 Organizational Plan 250.930 Role in hospital planning 250.940 Job descriptions 250.950 Nursing committees 250.960 Specialized nursing services 250.970 Nursing Care Plans 250.980 Nursing Records and Reports 250.990 Unusual Incidents 250.1000 Meetings 250.1010 Education Programs 250.1020 Licensure 250.1030 Policies and Procedures 250.1035 Domestic Violence Standards 250.1040 Patient Care Units 250.1050 Equipment for Bedside Care 250.1060 Drug Services on Patient Unit 250.1070 Care of Patients 250.1075 Use of Restraints 250.1080 Admission Procedures Affecting Care 250.1090 Sterilization and Processing of Supplies 250.1100 Infection Control 250.1110 Mandatory Overtime Prohibition 250.1120 Staffing Levels




250.1130 Nurse Staffing by Patient Acuity

SUBPART J: SURGICAL AND RECOVERY ROOM SERVICES

Section 250.1210 Surgery 250.1220 Surgery Staff 250.1230 Policies & Procedures 250.1240 Surgical Privileges 250.1250 Surgical Emergency Care 250.1260 Operating Room Register and Records 250.1270 Surgical Patients 250.1280 Equipment 250.1290 Safety 250.1300 Operating Room 250.1305 Visitors in Operating Room 250.1310 Cleaning of Operating Room 250.1320 Postoperative Recovery Facilities

SUBPART K: ANESTHESIA SERVICES

Section 250.1410 Anesthesia Service

SUBPART L: RECORDS AND REPORTS

Section 250.1510 Medical Records 250.1520 Reports

SUBPART M: FOOD SERVICE

Section 250.1610 Dietary Department Administration 250.1620 Facilities 250.1630 Menus and Nutritional Adequacy 250.1640 Diet Orders 250.1650 Frequency of Meals 250.1660 Therapeutic (Modified) Diets




250.1670 Food Preparation and Service 250.1680 Sanitation

SUBPART N: HOUSEKEEPING AND LAUNDRY SERVICES

Section 250.1710 Housekeeping 250.1720 Garbage, Refuse and Solid Waste Handling and Disposal 250.1730 Insect and Rodent Control 250.1740 Laundry Service 250.1750 Soiled Linen 250.1760 Clean Linen

SUBPART O: MATERNITY AND NEONATAL SERVICE

Section 250.1810 Applicability of other Parts of these regulations 250.1820 Maternity and Neonatal Service (Perinatal Service) 250.1830 General Requirements for All Maternity Departments 250.1840 Discharge of Newborn Infants from Hospital 250.1850 Rooming-In Care of Mother and Infant 250.1860 Special Programs 250.1870 Single Room Maternity Care SUBPART P: ENGINEERING AND MAINTENANCE OF THE PHYSICAL PLANT, SITE, EQUIPMENT, AND SYSTEMS – HEATING, COOLING, ELECTRICAL, VENTILATION,

PLUMBING, WATER, SEWER, AND SOLID WASTE DISPOSAL

Section 250.1910 Maintenance 250.1920 Emergency electric service 250.1930 Water Supply 250.1940 Ventilation, Heating, Air Conditioning, and Air Changing Systems 250.1950 Grounds and Buildings Shall be Maintained 250.1960 Sewage, Garbage, Solid Waste Handling and Disposal 250.1970 Plumbing 250.1980 Fire and Safety

SUBPART Q: CHRONIC DISEASE HOSPITALS




Section 250.2010 Definition 250.2020 Requirements

SUBPART R: PHARMACY OR DRUG AND MEDICINE SERVICE

Section 250.2110 Service Requirements 250.2120 Personnel Required 250.2130 Facilities for Services 250.2140 Pharmacy and Therapeutics Committee

SUBPART S: PSYCHIATRIC SERVICES

Section 250.2210 Applicability of other Parts of these Regulations 250.2220 Establishment of a Psychiatric Service 250.2230 The Medical Staff 250.2240 Nursing Service 250.2250 Allied Health Personnel 250.2260 Staff and Personnel Development and Training 250.2270 Admission, Transfer and Discharge Procedures 250.2280 Care of Patients 250.2290 Special Medical Record Requirements for Psychiatric Hospitals and Psychiatric

Units of General Hospitals or General Hospitals Providing Psychiatric Care 250.2300 Diagnostic, Treatment and Physical Facilities and Services

SUBPART T: DESIGN AND CONSTRUCTION STANDARDS

Section 250.2410 Applicability of these Standards 250.2420 Submission of Plans for New Construction, Alterations or Additions to Existing

Facility 250.2430 Preparation of Drawings and Specifications – Submission Requirements 250.2440 General Hospital Standards 250.2442 Fees 250.2443 Advisory Committee 250.2450 Details




250.2460 Finishes 250.2470 Structural 250.2480 Mechanical 250.2490 Plumbing and Other Piping Systems 250.2500 Electrical Requirements

SUBPART U: CONSTRUCTION REQUIREMENTSSTANDARDS FOR EXISTING HOSPITALS

Section 250.2610 Applicability of Subpart Uthese Standards 250.2620 Codes and Standards 250.2630 Existing General Hospital RequirementsStandards 250.2640 Details 250.2650 Finishes 250.2660 Mechanical 250.2670 Plumbing and Other Piping Systems 250.2680 Electrical Requirements

SUBPART V: SPECIAL CARE AND/OR SPECIAL SERVICE UNITS

Section 250.2710 Special Care and/or Special Service Units 250.2720 Day Care for Mildly Ill Children

SUBPART W: ALCOHOLISM AND INTOXICATION TREATMENT SERVICES

Section 250.2810 Applicability of Other Parts of These Requirements 250.2820 Establishment of an Alcoholism and Intoxication Treatment Service 250.2830 Classification and Definitions of Service and Programs 250.2840 General Requirements for all Hospital Alcoholism Program Classifications 250.2850 The Medical and Professional Staff 250.2860 Medical Records 250.2870 Referral 250.2880 Client Legal and Human Rights 250.APPENDIX A Codes and Standards (Repealed)

250.EXHIBIT A Codes (Repealed)




250.EXHIBIT B Standards (Repealed) 250.EXHIBIT C Addresses of Sources (Repealed)

250.ILLUSTRATION A Seismic Zone Map 250.TABLE A Measurements Essential for Level I, II, III Hospitals 250.TABLE B Sound Transmission Limitations in General Hospitals 250.TABLE C Filter Efficiencies for Central Ventilation and Air Conditioning Systems in

General Hospitals (Repealed) 250.TABLE D General Pressure Relationships and Ventilation of Certain Hospital Areas

(Repealed) 250.TABLE E Piping Locations for Oxygen, Vacuum and Medical Compressed Air 250.TABLE F General Pressure Relationships and Ventilation of Certain Hospital Areas 250.TABLE G Insulation/Building Perimeter AUTHORITY: Implementing and authorized by the Hospital Licensing Act [210 ILCS 85]. SOURCE: Rules repealed and new rules adopted August 27, 1978; emergency amendment at 2 Ill. Reg. 31, p. 73, effective July 24, 1978, for a maximum of 150 days; amended at 2 Ill. Reg. 21, p. 49, effective May 16, 1978; emergency amendment at 2 Ill. Reg. 31, p. 73, effective July 24, 1978, for a maximum of 150 days; amended at 2 Ill. Reg. 45, p. 85, effective November 6, 1978; amended at 3 Ill. Reg. 17, p. 88, effective April 22, 1979; amended at 4 Ill. Reg. 22, p. 233, effective May 20, 1980; amended at 4 Ill. Reg. 25, p. 138, effective June 6, 1980; amended at 5 Ill. Reg. 507, effective December 29, 1980; amended at 6 Ill. Reg. 575, effective December 30, 1981; amended at 6 Ill. Reg. 1655, effective January 27, 1982; amended at 6 Ill. Reg. 3296, effective March 15, 1982; amended at 6 Ill. Reg. 7835 and 7838, effective June 17, 1982; amended at 7 Ill. Reg. 962, effective January 6, 1983; amended at 7 Ill. Reg. 5218 and 5221, effective April 4, 1983 and April 5, 1983; amended at 7 Ill. Reg. 6964, effective May 17, 1983; amended at 7 Ill. Reg. 8546, effective July 12, 1983; amended at 7 Ill. Reg. 9610, effective August 2, 1983; codified at 8 Ill. Reg. 19752; amended at 8 Ill. Reg. 24148, effective November 29, 1984; amended at 9 Ill. Reg. 4802, effective April 1, 1985; amended at 10 Ill. Reg. 11931, effective September 1, 1986; amended at 11 Ill. Reg. 10283, effective July 1, 1987; amended at 11 Ill. Reg. 10642, effective July 1, 1987; amended at 12 Ill. Reg. 15080, effective October 1, 1988; amended at 12 Ill. Reg. 16760, effective October 1, 1988; amended at 13 Ill. Reg. 13232, effective September 1, 1989; amended at 14 Ill. Reg. 2342, effective February 15, 1990; amended at 14 Ill. Reg. 13824, effective September 1, 1990; amended at 15 Ill. Reg. 5328, effective May 1, 1991; amended at 15 Ill. Reg. 13811, effective October 1, 1991; amended at 17 Ill. Reg. 1614, effective January 25, 1993; amended at 17 Ill. Reg. 17225, effective October 1, 1993; amended at 18 Ill. Reg. 11945, effective July 22, 1994; amended at 18 Ill. Reg. 15390, effective October 10, 1994; amended at 19 Ill. Reg. 13355, effective September 15, 1995; emergency amendment at 20 Ill. Reg. 474, effective January 1, 1996, for a maximum of 150




days; emergency expired May 29, 1996; amended at 20 Ill. Reg. 3234, effective February 15, 1996; amended at 20 Ill. Reg. 10009, effective July 15, 1996; amended at 22 Ill. Reg. 3932, effective February 13, 1998; amended at 22 Ill. Reg. 9342, effective May 20, 1998; amended at 23 Ill. Reg. 1007, effective January 15, 1999; emergency amendment at 23 Ill. Reg. 3508, effective March 4, 1999, for a maximum of 150 days; amended at 23 Ill. Reg. 9513, effective August 1, 1999; amended at 23 Ill. Reg. 13913, effective November 15, 1999; amended at 24 Ill. Reg. 6572, effective April 11, 2000; amended at 24 Ill. Reg. 17196, effective November 1, 2000; amended at 25 Ill. Reg. 3241, effective February 15, 2001; amended at 27 Ill. Reg. 1547, effective January 15, 2003; amended at 27 Ill. Reg. 13467, effective July 25, 2003; amended at 28 Ill. Reg. 5880, effective March 29, 2004; amended at 28 Ill. Reg. 6579, effective April 15, 2004; amended at 29 Ill. Reg. 12489, effective July 27, 2005; amended at 31 Ill. Reg. 4245, effective February 20, 2007; amended at 31 Ill. Reg. 14530, effective October 3, 2007; amended at 32 Ill. Reg. 3756, effective February 27, 2008; amended at 32 Ill. Reg. 4213, effective March 10, 2008; amended at 32 Ill. Reg. 7932, effective May 12, 2008; amended at 32 Ill. Reg. 14336, effective August 12, 2008; amended at 33 Ill. Reg. 8306, effective June 2, 2009; amended at 34 Ill. Reg. 2528, effective January 27, 2010; amended at 34 Ill. Reg. 3331, effective February 24, 2010; amended at 35 Ill. Reg. ______, effective ____________.

SUBPART A: GENERAL Section 250.160 Incorporated and Referenced Materials

a) The following regulations and standards are incorporated in this Part:

1) Private and professional association standards:

A) American Society for Testing and Materials (ASTM), Standard No. E90-99 (2002): Standard Test Method for Laboratory Measurement of Airborne Sound Transmission Loss of Building Partitions and Elements, which may be obtained from the American Society for Testing and Materials, 100 Barr Harbor Drive, West Conshohocken, Pennsylvania 19428-2959. (See Section 250.2420.)

B) The following standards of the American Society of Heating,

Refrigerating, and Air Conditioning Engineers (ASHRAE), which may be obtained from the American Society of Heating, Refrigerating, and Air-Conditioning Engineers, Inc., 1791 Tullie Circle, N.E., Atlanta, Georgia 30329: (See Section 250.2480.)




i) ASHRAE Handbook of Fundamentals (2005); ii) ASHRAE Handbook for HVAC Systems and Equipment

(2004); iii) ASHRAE Handbook-HVAC Applications (2003).

C) The following standards of the National Fire Protection Association (NFPA), which may be obtained from the National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02169:

i) No. 101 (2000): Life Safety Code; (See Sections 250.2420,

250.2450, 250.2460, 250.2470, and 250.2490.) ii) No. 10 (1998): Standards for Portable Fire Extinguishers;

(See Section 250.1980.) iii) No. 13 (1999): Standards for the Installation of Sprinkler

Systems; (See Sections 250.2490 and 250.2670.) iv) No. 14 (2000): Standard for the Installation of Standpipe,

Private Hydrants and Hose Systems; (See Sections 250.2490 and 250.2670.)

v) No. 25 (1998): Standard for the Inspection, Testing and

Maintenance of Water-Based Fire Protection Systems; vi) No. 30 (1996): Flammable and Combustible Liquids Code;

(See Section 250.1980.) vii) No. 45 (1996): Standard on Fire Protection for

Laboratories Using Chemicals; viii) No. 54 (1999): National Fuel Gas Code; ix) No. 70 (1999): National Electrical Code; (See Sections

250.2440 and 250.2500.)




x) No. 72 (1999): National Fire Alarm Code; xi) No. 80 (1999): Standard for Fire Doors and Fire Windows;

(See Section 250.2450.) xii) No. 82 (1999): Standard on Incinerators and Waste and

Linen Handling Systems and Equipment; (See Section 250.2440.)

xiii) No. 90A (1999): Standard for Installation of Air

Conditioning and Ventilating Systems; (See Sections 250.2480 and 250.2660.)

xiv) No. 96 (1998): Standard for Ventilation Control and Fire

Protection of Commercial Cooking Operations; (See Section 250.2660.)

xv) No. 99 (1999): Standard for Health Care Facilities; (See

Sections 250.1410, 250.1910, 250.1980, 250.2460, 250.2480, 250.2490 and 250.2660.)

xvi) No. 101-A (2001): Guide on Alternative Approaches to

Life Safety; (See Section 250.2620.) xvii) No. 110 (1999): Standard for Emergency and Standby

Power Systems; xviii) No. 220 (1999): Standard on Types of Building

Construction; (See Sections 250.2470 and 250.2620.) xix) No. 221 (1997): Standard for Fire Walls and Fire Barrier

Walls; xx) No. 241 (1996): Standard for Safeguarding Construction,

Alteration and Demolition Operations; xxi) No. 255 and 258 (2000): Standard Method of Test of

Surface Burning Characteristics of Building Materials, and




Recommended Practice for Determining Smoke Generation of Solid Materials; (See Section 250.2480.)

xxii) No. 701 (1999): Standard Methods of Fire Tests for Flame

Propagation of Textiles and Films. (See Sections 250.2460 and 250.2650.)

D) American Academy of Pediatrics and American College of

Obstetricians and Gynecologists, Guidelines for Perinatal Care, Sixth Edition (2007), which may be obtained from the American College of Obstetricians and Gynecologists Distribution Center, P.O. Box 933104, Atlanta, Georgia 31193-3104 (800-762-2264). (See Section 250.1820.)

E) American College of Obstetricians and Gynecologists, Guidelines

for Women's Healthcare, Third Edition (2007), which may be obtained from the American College of Obstetricians and Gynecologists Distribution Center, P.O. Box 933104, Atlanta, Georgia 31193-3104 (800-762-2264). (See Section 250.1820.)

F) National Council on Radiation Protection and Measurements

(NCRP), Report No. 49: Structural Shielding Design and Evaluation for Medical Use of X-rays and Gamma Rays of Energies up to 10 MeV (1976) and NCRP Report No. 102: Medical X-Ray, Electron Beam and Gamma-Ray Protection for Energies Up to 50 MeV (Equipment Design, Performance and Use) (1989), which may be obtained from the National Council on Radiation Protection and Measurements, 7910 Woodmont Ave., Suite 800, Bethesda, Maryland 20814-3095. (See Sections 250.2440 and 250.2450.)

G) DOD Penetration Test Method MIL STD No. 282 (1995): Filter

Units, Protective Clothing, Gas-mask Components and Related Products: Performance Test Methods, which may be obtained from Naval Publications and Form Center, 5801 Tabor Avenue, Philadelphia, Pennsylvania 19120. (See Section 250.2480.)

H) National Association of Plumbing-Heating-Cooling Contractors

(PHCC), National Standard Plumbing Code (2003), which may be




obtained from the National Association of Plumbing-Heating-Cooling Contractors, 180 S. Washington Street, P.O. Box 6808, Falls Church, Virginia 22046 (703-237-8100).

I) The International Code Council, International Building Code

(2000), which may be obtained from the International Code Council, 4051 Flossmoor Road, Country Club Hills, Illinois 60477-5795. (See Section 250.2420.)

J) American National Standards Institute, Specifications for Making

Buildings and Facilities Accessible to, and Usable by, the Physically Handicapped (1968), which may be obtained from the American National Standards Institute, 25 West 433rd Street, 4th Floor, New York, New York 10036. (See Section 250.2420.)

K) Accreditation Council for Graduate Medical Education, Essentials

of Accredited Residencies in Graduate Medical Education (1997), which may be obtained from the Accreditation Council for Graduate Medical Education, 515 North State Street, Suite 2000, Chicago, Illinois 60610. (See Section 250.315.)

L) Joint Commission on Accreditation of Healthcare Organizations,

2006 Hospital Accreditation Standards (HAS), Standard PC.3.10, which may be obtained from the Joint Commission on Accreditation of Healthcare Organizations, One Renaissance Boulevard, Oakbrook Terrace, Illinois 60181. (See Section 250.1035.)

M) National Quality Forum, Safe Practices for Better Health Care

(2009), which may be obtained from the National Quality Forum, 601 13th Street, NW, Suite 500 North, Washington DC 20005, or from www.qualityforum.org.

2) Federal Government Publications:

A) Department of Health and Human Services, United States Public Health Service, Centers for Disease Control and Prevention, "Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2007" and "Guidelines for




Infection Control in Health Care Personnel, 1998, which may be obtained from National Technical Information Service (NTIS), U.S. Department of Commerce, 5285 Port Royal Road, Springfield, Virginia 22161. (See Section 250.1100.)

B) Department of Health and Human Services, United States Public

Health Service, Centers for Disease Control and Prevention, "Guidelines for Environmental Infection Control in Health-Care Facilities: Recommendations − Animals in Health Care Facilities", "Morbidity and Mortality Weekly Report", June 6, 2003/Vol. 52/No. RR-10, which may be obtained from the Centers for Disease Control and Prevention, 1600 Clifton Road, MS K-95, Atlanta, Georgia 30333.

C) Department of Health and Human Services, United States Public

Health Services, Centers for Disease Control and Prevention, "Guidelines for Hand Hygiene in Health-Care Settings", October 25, 2002, which may be obtained from the National Technical Information Services (NTIS), U.S. Department of Commerce, 5285 Port Royal Road, Springfield, Virginia 22161.

D) Department of Health and Human Services, United States Public

Health Service, Centers for Disease Control and Prevention, "Guidelines for Disinfection and Sterilization in Healthcare Facilities, 2008", which may be obtained from the Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, Georgia 30333.

b) All incorporations by reference of federal regulations and guidelines and the

standards of nationally recognized organizations refer to the regulations, guidelines and standards on the date specified and do not include any editions or amendments subsequent to the date specified.

c) The following statutes and State regulations are referenced in this Part:

1) State of Illinois statutes:

A) Hospital Licensing Act [210 ILCS 85].




B) Illinois Health Facilities Planning Act [20 ILCS 3960]. C) Medical Practice Act of 1987 [225 ILCS 60]. D) Podiatric Medical Practice Act of 1987 [225 ILCS 100]. E) Pharmacy Practice Act of 1987 [225 ILCS 85]. F) Physicians Assistant Practice Act of 1987 [225 ILCS 95]. G) Illinois Clinical Laboratory and Blood Bank Act [210 ILCS 25]. H) X-ray Retention Act [210 ILCS 90]. I) Safety Glazing Materials Act [430 ILCS 60]. J) Mental Health and Developmental Disabilities Code [405 ILCS 5]. K) Nurse Practice Act [225 ILCS 65]. L) Health Care Worker Background Check Act [225 ILCS 46]. M) MRSA Screening and Reporting Act [210 ILCS 83]. N) Hospital Report Card Act [210 ILCS 88]. O) Illinois Adverse Health Care Events Reporting Law of 2005 [410

ILCS 522]. P) Smoke Free Illinois Act [410 ILCS 82].

2) State of Illinois rules:

A) Department of Public Health, Illinois Plumbing Code (77 Ill. Adm. Code 890).

B) Department of Public Health, Sexual Assault Survivors Emergency

Treatment Code (77 Ill. Adm. Code 545).




C) Department of Public Health, Control of Communicable Diseases Code (77 Ill. Adm. Code 690).

D) Department of Public Health, Food Service Sanitation Code (77 Ill.

Adm. Code 750). E) Department of Public Health, Public Area Sanitary Practice Code

(77 Ill. Adm. Code 895). F) Department of Public Health, Maternal Death Review (77 Ill.

Adm. Code 657). G) Department of Public Health, Control of Sexually Transmissible

Diseases Code (77 Ill. Adm. Code 693). H) Department of Public Health, Control of Tuberculosis Code (77 Ill.

Adm. Code 696). I) Department of Public Health, Health Care Worker Background

Check Code (77 Ill. Adm. Code 955). J) Department of Public Health, Language Assistance Services Code

(77 Ill. Adm. Code 940). K) Department of Public Health, Private Sewage Disposal Code (7 Ill.

Adm. Code 905). L)K) Capital Development Board, Illinois Accessibility Code (71 Ill.

Adm. Code 400). M)L) State Fire Marshal, Boiler and Pressure Vessel Safety (41 Ill. Adm.

Code 120). N)M) State Fire Marshal, Fire Prevention and Safety (41 Ill. Adm. Code

100). O)N) Illinois Emergency Management Agency, Standards for Protection

Against Radiation (32 Ill. Adm. Code 340).




P)O) Illinois Emergency Management Agency, Use of X-rays in the Healing Arts Including Medical, Dental, Podiatry, and Veterinary Medicine (32 Ill. Adm. Code 360).

(Source: Amended at 35 Ill. Reg. ______, effective ____________)

SUBPART P: ENGINEERING AND MAINTENANCE OF THE PHYSICAL PLANT, SITE, EQUIPMENT, AND SYSTEMS – HEATING, COOLING, ELECTRICAL, VENTILATION,

PLUMBING, WATER, SEWER, AND SOLID WASTE DISPOSAL Section 250.1910 Maintenance The hospital shall haveThere shall be an organized engineering and/or maintenance department under competent supervision. The requirements of NFPA Standard No. 99 (1993), "Health Care Facilities Code," shall apply in addition to the following:

a) The administrator shall be responsibleResponsibility for maintenance of the physical plant site, equipment and systems andshall be vested in the administrator who may delegate responsibility to the proper employees. Maintenance services shall be under the supervision of a qualified engineer or persons who have had commensurate experience in the maintenance of public or private plants, preferably hospitals.

b) Personnel engaged in maintenance activities shall receive orientation and follow-

up training, including training in principles of asepsis, cross-infection control, and safe practices.

c) The hospital shall haveThere shall be an effective, organized, detailed preventive

maintenance program. Written instructions for operating and maintaining equipment and the various mechanical, electrical, and other systems contained in the hospital shall be available to maintenance personnel.

d) Maintenance and repairs shall be carried out in accordance with applicable codes,

rules, regulations, standards and requirements of local jurisdictions, the State Fire Marshal, and the Department of Public Health.

e) Space and equipment shall be provided for the managerial activities of the

supervisor of maintenance for repair work and for storage of maintenance materials. PaintsThe storage of paints and oils shall not be stored in patient areas




shall not be permitted. f) The hospital structure and its component parts and facilities shall be kept in good

repair and maintained with consideration for the safety and comfort of the occupants of the building. Mechanical and electrical equipment shall be maintained in good repair and operating condition at all times.

g) Roads, walks, and parking areas shall be properly maintained. (Refer to Subpart

T and Subpart U of this Part.) (Source: Amended at 35 Ill. Reg. ______, effective ____________)

Section 250.1980 Fire and Safety

a) Buildings and equipment shall be so maintained so as to prevent fire and other hazards to personal safety.

b) Exits, stairways, doors, and corridors shall be kept free of obstructions. c) Flammable and combustible liquids shall be labeled, stored, handled and used in

compliance with the requirements of NFPA the National Fire Protection Association (NFPA) Standard No.30, "Flammable and Combustible Liquids Code."

d) Flammable and non-flammable gases shall be labeled, handled, and used in

compliance with the requirements of NFPA Standard No.99 (1993), "Health Care Facilities Code." Separate storage for flammable and oxidizing gases shall be provided.

e) A master fire plan, developed to suit the needs of the facility, and acceptable to

the Department, shall be maintained. f) Fire regulations listing the fire stations, procedures, and staff emergency duties by

title or position, shall be posted conspicuously on each floor at appropriate locations, and shall be available in each unit, section, and department.

g) Employees shall be trained in procedures to be followed in the master fire plan. h) Fire drills shall be conducted at irregular intervals at least l2 times per year. A




record shall be kept of the staff performance and results, and indicated corrective measures shall be made.

i) Portable fire extinguishers, provided in accordance with NFPA Standard No.l0

(1990), "Installation of Portable Fire Extinguishers", shall be inspected at least annually, recharged or repaired as needed, and labeled with the dates of the last inspection.

j) Sprinkler systems, fire hoses, fire detection and alarm devices, and other

equipment for use in the fire safety program shall be connected and maintained in a fully functional condition at all times.

k) Fire detection and protection systems shall be inspected no less than twice a year

by a recognized competent authority. A written report of the inspection shall be kept on file at the hospital for at least three years following the date of inspection.

l) The hospital shall maintain a procedure for reporting all accidents to patients,

employees, or visitors to a designated administrative officer on a standard form adopted for thatthe purpose, all accidents to patients, staff employees, or visitors. The report shall include all pertinent information and shall be kept on file for not less than six years after the occurrence reported.

m) The hospital shall maintain a procedure to investigate fires. A written report of

the investigation containing all pertinent information shall be made. The report shall remain on file for not less than six years.


SUBPART T: DESIGN AND CONSTRUCTION STANDARDS

Section 250.2450 Details

a) Compartmentation, exits, automatic extinguishing systems, and other details relating to fire prevention and fire protection shall comply with requirements listed in the appropriate sections of the NFPA 101National Fire Protection Association Standard 101 (1994), "Life Safety Code."

b) Items such as drinking fountains, telephone booths, vending machines, and

portable equipment shall be located so as not to restrict corridor traffic or reduce




the corridor width below the required minimum. c) Doors

1) Doors to patient rooms shall not be lockable from inside the room. 2) Special Locking Arrangements: Electronic locking devices may be

installed at specific locations to restrict egress or ingress for patient/staff safety or security, provided that each of the following is complied with and after receiving approval from the Department: A) The facility shallmust submit a narrative to the Department

providing a rationale for having a locked door in a required means of egress. The rationale shallmust relate to security issues.

B) The building shallmust be protected by a sprinkler or fire detection

system approved by the Department. C) All locking system components shallmust be U.L. listed. D) Cross corridor, smoke, or control doors that are located in a

required means of egress may only be secured only with electronic locks and automatic release devices. The use of only manual keys or tools only to unlock the door is not permitted.

E) Locked doors shallmust have continuous staff supervision (direct

or electronic remote). F) No other type of locking arrangement may be used in a required

means of egress. G) All locked doors shallmust release automatically with actuation of

the fire alarm system. H) All doors shallmust release automatically with loss of electrical

power to the locking device. I) All locks shallmust initiate an irreversible process that will release

the lock within 15 seconds whenever a force of not more than 15




pounds is continuously applied to the release device (lever type handle or panic bar) for a period of not more than three3 seconds. Relocking of such doors shall be by manual means only. Operation of the release device activates a sign in the vicinity of the door to assure those attempting to exit that the system is functional. Delays of up to 30 seconds may be acceptable based on the program narrative.

J) Permanent signs shallmust be posted on locked doors that state:

"Push until alarm sounds. Door will be opened in 15 seconds." Sign letters shallmust be at least 1one inch high with 1/8-inch stroke. Signs may be omitted for security reasons based on the Department's review of the hospital's written rationale.

K) Emergency lighting shallmust be provided at all locked door

locations. L) The local fire department shallmust be fully apprised of locked

doors or units and all related details of the system. M) Any discharge exit door may be locked against entry. N) Additional electronic release of locked doors initiated from a staff

duty station shallis to be provided. O) No more than one such device may be installed in any path of

travel to exit discharge.

P) Hospitals shall have policies and procedures for readily gaining access to a locked bathroom in a patient's room. (Section 11.6 of the Act)

d) The minimum width of all doors to rooms needing access for beds or stretchers

shall be 3 feet, 8 inches3'8". Doors to rooms needing access for wheelchairs shall have a minimum width of 2 feet, 10 inches2'10".

e) Doors on all openings between corridors and rooms or spaces subject to

occupancy, except elevator doors, shall be swing type. Openings to showers, baths, patient toilets, and other small wet-type areas not subject to fire hazard are




exempt from this requirement. Sliding doors with a break and swing feature are acceptable.

f) Doors, except those to spaces such as small closets thatwhich are not subject to

occupancy, shall not swing into corridors in a manner that might obstruct traffic flow or reduce the required corridor width. (Large walk-in type closets are considered as occupiable spaces.)

g) Windows shall be designed so that persons cannot accidentally fall out of them

when they are open, or shall be provided with guards. h) Glazing

1) Doors, sidelights, borrowed lights, and windows in which the glazing

extends down to within 18 inches of the floor (thereby creating possibility of accidental breakage by pedestrian traffic) shall be glazed with safety glass or plastic glazing material that will resist breaking and will not create dangerous cutting edges when broken. Similar materials shall be used in wall openings or recreation rooms and exercise rooms. Safety glass or plastic glazing materials shall be used for shower doors and bath enclosures. Fire-rated glass shall be used where required for fire safety.

2) Safety glass or plastic glazing materials as noted above shall be used in

windows and doors in patient areas of psychiatric facilities, if required by the program. See the Safety Glazing Materials Act for other requirements.

i) Where labeled fire doors are required, these shall be certified by an independent

testing laboratory as meeting the construction requirements equal to those for fire doors in NFPA Standard No. 80, Standard for Fire Doors and Fire Windows. (1990), "Fire Doors and Windows." Reference to a labeled door includes labeled frame and hardware.

j) Elevator shaft openings shall be Classclass B 1½-hour-labeled fire doors. k) Linen and refuse chutes shall meet or exceed the following requirements:

1) Service openings to chutes shall not be located in corridors or

passageways but shall be located in a room of construction having a fire-




resistance of not less than one hour. Doors to such rooms shall be not less than Classclass C ¾-hour-labeled doors.

2) Service openings to chutes shall have approved self-closing Classclass B

1½-hour-labeled fire doors. 3) The minimumMinimum cross-sectional dimension of gravity chutes shall

be not less than 2 feet2'0". 4) Chutes shall discharge directly into collection rooms separated from

incinerator, laundry, or other services. Separate collection rooms shall be provided for trash and for linen. The enclosure construction for such rooms shall have a fire-resistance rating of not less than two hours, and the doors thereto shall be not less than Classclass B 1½-hour-labeled fire doors. External discharge containers need not be enclosed.

5) Gravity chutes shall extend through the roof with provisions for

continuous ventilation as well as for fire and smoke ventilation. Openings for fire and smoke ventilation shall have an effective area of not less than that of the chute cross-section and shall be not less than 4 feet4'0" above the roof and not less than 6 feet6'0" clear of other vertical surfaces. Fire and smoke ventilating openings may be covered with single strength sheet glass or stronger.

6) See NFPA Standard No.82, Standard on Incinerators and Waste and Linen

Handling System and Equipment(1990), "Incinerators and Rubbish Handling," for other requirements.

l) Dumbwaiters, conveyors, and material-handling systems shall not open directly

into a corridor or exitway but shall open into a room enclosed by construction having a fire-resistance rating of not less than one hour and provided with Classclass C ¾-hour-labeled fire doors. Service entrance doors to vertical shafts containing dumbwaiters, conveyors, and material-handling systems shall be not less than Classclass B 1½-hour-labeled fire doors. Where horizontal conveyors and material-handling systems penetrate fire-rated walls or smoke partitions, such openings shallmust be provided with Classclass B 1½-hour-labeled fire doors for two-hour walls and Classclass C ¾-hour-labeled fire doors for one-hour walls or partitions.




m) Thresholds and expansion joint covers shall be made flush with the floor surface to facilitate use of wheelchairs and carts.

n) Grab bars shall be provided at all patients' toilets, showers, tubs, and sitz baths.

The bars shall have 1½-inch clearance to walls and shall have sufficient strength and anchorage to sustain a concentrated load of 250 pounds.

o) Recessed soap dishes shall be provided at showers and bathtubs. p) Location and arrangement of hand-washinghandwashing facilities shall permit

their proper use and operation. Particular care shallshould be given to the clearances required for blade-type operating handles.

q) Mirrors shall not be installed at hand-washinghandwashing fixtures in food

preparation areas or in sensitive areas such as nurseries, clean and sterile suppliesNurseries, Clean and Sterile Supplies, and scrub sinks.

r) Paper towel dispensers and waste receptacles (or electric hand dryers) shall be

provided at all hand-washinghandwashing facilities except scrub sinks. s) Lavatories and hand-washinghandwashing facilities shall be securely anchored to

withstand an applied vertical load of not less than 250 pounds on the front of the fixture.

t) Radiation protection requirements of X-ray and gamma ray installations shall

conform with the National Council on Radiation Protection and Measurements (NCRP), Report No. 4934: Structural Shielding Design and Evaluation for Medical Use of X-rays and Gamma Rays of Energies up to 10 MeV (1976) and NCRP Report No. 102:; Medical X-Ray, Electron Beam and Gamma-Ray Protection for Energies Up to 50 MeV (Equipment Design, Performance and Use)(1989). Provision shall be made for testing the completed installation. All and all defects shallmust be corrected before use.

u) Ceiling heights shall be as follows:

1) Boiler rooms shall have ceiling clearances not less than 2 feet, 6

inches2'6" above the main boiler header and connecting piping. 2) Radiographic, operating, and delivery roomsOperating and Delivery




Rooms, and other rooms containing ceiling-mounted equipment or ceiling-mounted surgical light fixtures, shall have height required to accommodate the equipment or fixtures.

3) All other rooms shall have not less than 8-foot8'0" ceilings, except that

ceilings in corridors, storage rooms, toilet rooms, and other minor rooms shall be not less than 7 feet, 8 inches7'8". Suspended tracks, rails, and pipes located in the path of normal traffic shall be not less than 6 feet, 8 inches6'8" above the floor.

v) Recreation rooms, exercise roomsRooms, Exercise Rooms, and similar spaces

where impact noises may be generated shall not be located directly over patient bed areas, or delivery or operating suites, unless special provisions are made to minimize such noise.

w) Rooms containing heat-producing equipment (such as boiler or heater rooms and

laundriesBoiler or Heater Rooms and Laundries) shall be insulated and ventilated to prevent any floor surface above from exceeding a temperature of 10°F. (6°C.) above the ambient room temperature.

x) Noise reduction criteria shown in Table Bthe following table shall apply to

partition, floor, and ceiling construction in patient areas. (See Section 250.Table B for sound transmission limitations in general hospitals.) (Table B is notNot applicable to existing hospitals.)

y) Elevators. All hospitals having patients' facilities (such as bedrooms, dining

rooms, or recreation areasBedrooms, Dining Rooms, or Recreation Areas) or critical services (such as operating, delivery, diagnostic, or therapyOperating, Delivery, Diagnostic, or Therapy) located on other than the main entrance floor shall have electric or electrohydraulic elevators. 1) Number of Elevators

A) At least one hospital-type elevator shall be installed where 1 to 59

patient beds are located on any floor other than the main entrance floor.

B) At least two hospital-type elevators shall be installed where 60 to

200 patient beds are located on floors other than the main entrance




floor, or where the major inpatient services are located on a floor other than those containing patient beds. (Elevator service may be reduced for otherthose floors which provide only partial inpatient services.)

C) At least three hospital-type elevators shall be installed where 201

to 350 patient beds are located on floors other than the main entrance floor, or where the major inpatient services are located on a floor other than those containing patient beds. (Elevator service may be reduced for those floors which provide only partial inpatient services.)

D) For hospitals with more than 350 beds, the number of elevators

shall be determined from a study of the hospital plan and the estimated vertical transportation requirements.

2) Cars and Platforms. Cars of hospital-type elevators shall have dimensions

that will accommodate a patient bed and attendants and shall be at least 5 feet, 8 inches by 7 feet, 6 inches5'8" x 7'6". The car door shall have a clear opening of not less than 3 feet, 8 inches3'8".

3) Leveling. Elevators shall be equipped with an automatic leveling device

of the two-way automatic maintaining type with an accuracy of +½ inch. 4) Operation. Elevators, except freight elevators, shall be equipped with a

two-way special service key-operated switch to permit cars to bypass all landing button calls and be dispatched directly to any floor.

5) Elevator controls, alarm buttons, and telephones shall be accessible to

physically handicapped. 6) Elevator call buttons, controls, and door safety stops shall be of a type that

will not be activated by heat or smoke. 7) Inspections and tests shall be made and written certification shall be

furnished that the installation meets the requirements set forth in this Section and all applicable NFPA and localsafety regulations and codes.

z) Provisions for Natural Disasters




1) General Requirements. An emergency radio communication system is

desirable in each facility. If installed, this system shall be self-sufficient in a time of emergency and shall also be linked with the available community system and state emergency medical network system, including connections with police, fire, and civil defense systemssystem.

2) Earthquakes. In regions where local experience shows that earthquakes

have caused loss of life or extensive property damage, buildings and structures shall be designed to withstand the force assumptions specified in the International Building CodeBOCA National Building Code. Seismic zones are identified on the map on shown in Section 250.Illustration A.

3) Tornadoes and Floods. Special provisions shall be made in the design of

buildings in regions where local experience shows loss of life or damage to buildings resulting from tornadoes or floods.


Section 250.2460 Finishes

a) Cubicle and window curtains and draperies shall be noncombustible or rendered flame retardant and shall pass both the large and small scale tests of NFPANational Fire Protection Association Standard No. 701, Standard Methods of Fire Tests for Flame Propagation of Textiles and Films."Fire Tests for Flame-Resistant Textiles and Films."

b) Flame spread and smoke developed ratings of finishes shall be in accordance with

NFPA Standard No.101, "Life Safety Code." c) Floors in areas and rooms in which flammable anesthetic agents are stored or

administered to patients shall comply with NFPA Standard No.99, Standard for Health Care Facilities."Health Care Facilities Code." Conductive flooring may be omitted from emergency treatment, operating, and delivery rooms provided that a written resolution is signed by the hospital governing board stating that no flammable anesthetic agents will be used in these areas, and provided that appropriate notices are permanently and conspicuously affixed to the wall in each such area and room.




d) Floor materials shall be easily cleanable and have wear resistance appropriate for

the location involved. Floors in areas used for food preparation or food assembly shall be water resistantwaterresistant and greaseproof. Joints in tile and similar material in such areas shall be resistant to food acids. Floors in toilets, baths, janitor's closets, and similar areas shall be water resistant. In all areas frequently subject to wet cleaning methods, floor materials shall not be physically affected by germicidal and cleaning solutions.

e) Wall bases in kitchens, operating and delivery rooms, soiled work rooms, and

other areas that are frequently subject to wet cleaning methods shall be made integral and coved with the floor, tightly sealed to the wall, and constructed without surface voids that can harbor vermin.

f) All wall finishes shall be washable and, in the immediate area of plumbing

fixtures, shall be smooth and moisture resistant. Walls in surgery, delivery, kitchens and in other spaces subject to frequent cleaning shall have finishes that are smooth, sanitary, washable, and capable of withstanding treatment with harsh chemicals. The finishes shall be capable of being thoroughly cleaned, including concealed spacesbe of suitable materials.

g) Floor and wall penetrations by pipes, ducts, and conduits shall be tightly sealed to

minimize entry of vermin, smoke, and fire. Joints of structural elements shall be similarly sealed.

h) Ceilings shall be cleanable and shall meet the following criteria:

1) Unrestricted general accessThose finishes in unrestricted areas such as

patient rooms, corridors, officesoffice, and waiting areas are general access areas and may have non-restricted acoustical ceilings installed.

2) CeilingsThose finishes in wet areas subject to frequent cleaning such as

shower rooms, and toilet rooms, and dietary units shall have finishes that are smooth, sanitary, washable, and capable of withstanding treatment with harsh chemicals. The finishes shallmust be capable of being thoroughly cleaned, including any concealed spaces that may be present.

3) Food preparation areas subject to frequent cleaning shall have ceiling

finishes that are smooth, sanitary, washable, and capable of withstanding




treatment with harsh chemicals. 4) CeilingCeilings finishes in areas such as clean corridors, central sterile

supply spaces, specialized radiographic rooms, and minor surgical procedure rooms shallmust be smooth, scrubbable, non-absorptive, non-perforated, capable of withstanding cleaning with harsh chemicals, and without crevices that can harbor mold and bacterial growth. If a lay-in ceiling is provided, it shall be designed to prevent the passage of particles from the cavity above the ceiling plane into the semi-restricted environment. Perforated, tegular, serrated, cut, or highly textured tiles are not acceptable.

5) Ceiling finishes in areas such as operating rooms and other rooms where

open wounds are present shall be monolithic, scrubbable, and capable of withstanding harsh chemicals. Cracks or perforations in these ceilings are not allowed.

i) The following areas shall have acoustical ceilings:

1) Corridors in patient areas; 2) Nurses' stations; 3) Labor rooms; 4) Day rooms; 5) Recreation rooms; 6) Dining areas; and 7) Waiting areas.

(Source: Amended at 35 Ill. Reg. ______, effective ____________) Section 250.2470 Structural

a) In addition to compliance with the standards set forth in this Subpart, all applicable local or State building codes and regulations shallmust be observed.




b) The buildings and all parts thereof shall be of sufficient strength to support all

dead, live, and lateral loads without exceeding the working stresses permitted for the materials of their construction in generally accepted good engineering practice.

c) Special provision shall be made for machines or apparatus loads that would cause

a greater load than the specified minimum live load. d) Consideration shall be given to structural members and connections of structures

that may be subject to earthquakes or tornadoes. (See Section 250.2450(z).) Floor areas where partition locations are subject to change shall be designed to support, for the partition, a uniformly distributed load of 25 p.s.f.

e) Construction. Construction shall be in accordance with the requirements of

NFPANational Fire Protection Association Standard No. 101, (2000): "Life Safety Code," and the minimum requirements contained in this subsection (e). 1) Foundations shall rest on natural solid ground and shall be carried to a

depth of not less than 1one foot below the estimated frost line or shall rest on leveled rock or load-bearing piles or caissons when solid ground is not encountered. Footings, piers, and foundation walls shall be adequately protected against deterioration from the action of ground water. Test borings shall be taken to establish proper soil-bearing values for the soil at the building site.

2) Assumed live loads shall be in accordance with the BOCA International

Building Code. 3) All hospitals of any height shall be of Type I or Type II construction as

established by NFPA 101, Life Safety Code, (2000) and NFPA 220, Standard on Types of Building Construction(1999).


Section 250.2480 Mechanical

a) General




1) Mechanical systems shall be tested, balanced, and operated to demonstrate that the installation and performance of these systems conform to the requirements of the plans and specifications.

2) Upon completion of the contract, the owner shall obtain a complete set of

manufacturer'smanufacturers installation, operating, maintenance, and preventive maintenance instructions, and a parts list with numbers and a description for each piece of equipment. The owner shall also obtain instruction in the operational use of the systems and equipment as required.

b) Thermal and Acoustical Insulation

1) Insulation shall be provided for the following thatwhich are located within

the building: A) Boilers, smoke breeching, and stacks. B) Steam supply and condensate return piping. C) Hot water piping above 120° F and all hot water heaters,

generators, and converters. Exposed hot water supplies to fixtures need not be insulated except where exposed to contact by the physically handicapped.

D) Chilled water, refrigerant, other process piping, and equipment

operating with fluid temperatures below ambient dew point. E) Water supply, storm, and drainage piping on which condensation

may occur. F) Air ducts and casings with outside surface temperature below

ambient dew point. G) Other piping, ducts, and equipment as necessary to maintain the

efficiency of the system. 2) Insulation on cold surfaces shall include an exterior vapor barrier.




3) Insulation, including finishes and adhesives on exterior surfaces of ducts and equipment, shall have a flame spread rating of 25 or less and a smoke developed rating of 50 or less as determined by an independent testing laboratory in accordance with NFPA-Standard No. 255 (1990), "Standard Method of Test of Surface Burning Characteristics of Building Materials. Material." A) Pipe insulation shall have a flame spread rating of 25 or less and a

smoke developed rating of 150 or less. B) All construction exposed to air flow in air distribution plenums

shall have a flame spread rating of 25 or less and a smoke developed rating of 50 or less.

4) No duct linings shall be permitted downstream of the 90% filters serving

areas requiring 90% filtration. c) Steam and Hot Water Systems

1) Boilers shall have the capacity to supply the normal requirements of all

systems and equipment. The number and arrangement of boilers shall be such that when one boiler breaks down or is temporarily taken out of service, the capacity of the remaining boilersboiler(s) shall be sufficient to provide hot water service for clinical, dietary, and patient use; steam for sterilization and dietary purposes; heating for surgery, delivery, labor, recovery, intensive care, nursery, and general patient rooms.

2) Boiler feed pumps, heating circulating pumps, condensate return pumps

and fuel oil pumps shall be connected and installed to provide normal and standby service.

3) Supply and return mains and risers of cooling, heating, and process steam

systems shall be valved to isolate the various sections of each system. Each piece of equipment shall be valved at supply and return ends.

4) Humidifiers used in conjunction with air handling systems shall be of the

direct steam injection type. d) Air Conditioning, Heating and Ventilating Systems




1) This Part is intendedIt is the intent of these regulations to provide a

comfortable, clean, controlled environment for the hospital by employing the most economical and energy efficient systems consistent with these minimum requirements. A) The minimum requirements as set forth in this Partthese

regulations in no way relieve the designer from providing system capacities and components as required to maintain control of air quality, odor, ventilation rates, space temperatures, and space humidity as set forth in this Partthese regulations.

B) The design of air conditioning, heating and ventilation systems

shall be based on no less than the recommended outdoor design conditions listed in the ASHRAE Handbook of Fundamentals (1981) for 99% occurrence (winterWinter) and 1% occurrence (summerSummer).

2) Ventilation Systems

A) Air handling systems shall conform to NFPA Standard No. 90A,

Standard for(1989), " Installation of Air Conditioning and Ventilating Systems."

B) Fire dampers, smoke dampers, and smoke control systems shall be

constructed, located, and installed in accordance with the requirements of NFPA Standard No. 90A, Standard for (1989), "Installation of Air Conditioning and Ventilating Systems."

C) Ducts thatwhich penetrate construction intended for x-ray or other

ray protection shall be protected to preserve the effectiveness of the protection.

D) Outdoor air intakes shall be located at least 15 feet from exhaust

outlets of ventilation systems, combustion equipment stacks, medical/surgical vacuum systems, or plumbing vents, or from areas thatwhich may collect vehicular exhaust or other noxious fumes unless other provisions are made to minimize recirculation of exhaust into outdoor air intakes. Plumbing and vacuum vents




that terminate above the level of the top of the air intake shallmay be located no closer than 10as close as ten feet. The bottom of outdoor air intakes serving central systems shall be located as high as practical but at least 6six feet above ground level, or if installed above the roof, 3three feet above the roof level.

E) Exhaust outlets from areas that may be contaminated by dangerous

or noxious dust, fumes, mists, gases, odors, infectious material, or other contaminants harmful to people shall be above the roof level. The discharge to the atmosphere shall be located as far as possible but not less than 25 feet from any operable window, door, and/or outdoor intake for a fan thatwhich discharges air to an occupied space.

F) The ventilation systems shall be designed and balanced to provide

the ventilation and pressure relationships hereinafter specified in this Section.

G) If the ventilation rates required (as hereinafter specified in this

Section) do not provide sufficient make-up air for use by hoods, safety cabinets, and exhaust fans, the additional make-up air shall be provided to maintain required pressure balance.

H) An all-outdoor air system may be used where required by local

codes, provided that some form of air-to-air or air-to-water heat recovery system will be included to reclaim the energy otherwise discharged with the air exhausted to the outside.

I) To provide maximum energy conservation, air supplied to patient

care areas not required as make-up air for 100% exhaust systems shall be recirculated. Any air within the hospital thatwhich is circulated between patient rooms, or patient rooms and other areas of the hospital, shall pass through filters having an efficiency of 90% (see subsection (d)(3) on filters below).

J) To provide maximum energy conservation, air supplied to

housekeeping, administration and other nonsensitive areas not required as make-up air for 100% exhaust systems shall be recirculated. These areas require filters having a minimum




efficiency of 30% on the inlet side of the air handling unitAir Handling Unit.

K) When a central system serves areas with different filtration

requirements, the most stringent filtration requirement shallwill be provided for the complete system.

L) All outside air supplied to patient care areas shall pass through

90% filters (see subsection (d)(3) on filters below). M) Minimum air circulation requirements indicated in this

Sectionhereinafter are applicable to occupied spaces. During unoccupied periods, minimum air circulation may be provided as required to maintain space design temperature conditions.

N) Where fan coil or terminal room unit systems are provided in areas

to be occupied by patients, through-the-wall outside air ventilation is not acceptable. A separate central ventilation system, with final filters having a minimum efficiency of 90%, shall supply the required outdoor air ventilation.

3) Filters

A) All central ventilation or air conditioning systems shall be

equipped with filters having efficiencies no less than those specified in the area requirements.

B) Where two filter beds are required, filter bed No. 1 shall be located

upstream of the conditioning equipment and filter bed No. 2 shall be located downstream of the supply fan and conditioning equipment.

C) Where only one filter bed is required, it shall be located upstream

of the air conditioning equipment. D) All filter efficiencies shall be average atmospheric dust spot

efficiencies tested in accordance with ASHRAE Handbook of Fundamentals (1981).




E) Filter frames shall be durable and shall provide an airtight fit with the enclosing duct work. All joints between filter segments and enclosing duct work shall be gasketed or sealed to provide a positive seal against air leakage.

F) A local indicating device shall be installed across each filter bed

serving central air systems to measure the static pressure drop across the bed.

e) Area Requirements: These requirements are listed in outline format.

1) Administration, Public Area, Medical Records, and Housekeeping Offices.

A) Filters:

i) Central ventilation systems shall be provided with prefilters having a minimum efficiency of .................... 30%

ii) Units thatwhich recirculate air within a room shall

be provided with filters having a minimum efficiency of .................................................................. 10%

B) Space Design Conditions:

i) Temperature, dry bulb ................................................... 75° ii) Relative Humidity, winter, minimum ........................... 30% iii) Relative Humidity, summer, maximum ........................ 60%

C) Air Circulation:

i) Total air supplied to each space shall be as required to maintain space design conditions.

ii) Outdoor air supplied shall be no less than 20% of the total

air supplied.

D) Space Pressurization:




Ventilation system shall be designed and balanced so that space pressure, in relation to surrounding areas of the building, is .............................................................................. neutral

E) Recirculation of air within room permitted ............................ yes

2) Laboratories A) Filters:

i) Central ventilation systems shall be provided with

prefilters having a minimum efficiency of .................... 30% and final filters having a minimum efficiency of .......... 90% ii) Units thatwhich recirculate air within a room shall

be provided with filters having a minimum efficiency of .................................................................. 30%



C) Air Circulation:



air supplied.

D) Space Pressurization: Ventilation system shall be designed and balanced so

that space pressure, in relation to surrounding areas of the building, is ..................................................................... negative




E) Recirculation of air within room permitted except in areas, as listed below, where all air must be exhausted directly to the outdoors ........................................................ yes

F) Air from the following areas shall be exhausted directly to the

outdoors:

i) All fume hoods ii) Histology iii) Bacteriology iv) Glass-washing areas Washing Areas

G) All air exhausted from fume hoods shall be made up with outside

air. H) Laboratory hoods shall meet the following general requirements:

i) Havehave an average face velocity of not less than 75 feet

per minute;. ii) Bebe connected to an exhaust system thatwhich is separate

from the building exhaust system;. iii) Havehave an exhaust duct system of noncombustible,

corrosion-resistant material consistent with the usage of the hood; and.

iv) Havehave the exhaust fan located at the discharge end of

the duct system unless provided with welded stainless steel duct from fan outlet to termination.

I) Laboratory hoods shall meet the following special requirements:

i) Each hood thatwhich processes infectious or radioactive

materials shall have a minimum face velocity of 100 feet per minute, shall be connected to an independent exhaust




system, shall be provided with filters with 99.97 percent efficiency (based on the DODDOP, dioctylphthalate, test method as described in DODDOP Penetration Test Method MIL STD No. 282 (1976): Filtered Units, Protective Clothing, Gas-Mask Components and Related Products: Performance Test Methods) in the exhaust system, and shall be designed and equipped to permit the safe removal, disposal and replacement of contaminated filters.

ii) Duct systems serving hoods in which radioactive and/or

strong oxidizing agents such as prechloric or nitric acid are used shall be constructed of stainless steel and shall be equipped with wash-down facilities.

3) Morgue and Autopsy Suite

A) Filters:

i)Central ventilation systems shall be provided with prefilters having a minimum efficiency of .................... 30% ii)and final filters having a minimum efficiency of ....... 90%

B) Space Design Conditions: i) Temperature, dry bulb ................................................... 75° ii) Relative Humidity, winter, minimum ........................... 30% iii) Relative Humidity, summer, maximum ........................ 60%

C) Air Circulation:



air supplied.

D) Space Pressurization:




Ventilation system shall be designed and balanced so that space pressure, in relation to surrounding areas of the building, is ...................................................................... negative

E) Recirculation of air within room permitted .......................... no F) Air from the following areas shall be exhausted directly to the

outdoors:

i) Autopsy ii) Non-refrigerated body holding rooms

4) Radiology Suite; X-Ray Diagnostic, Fluoroscopy, and Special Procedures A) Filters:

i) Central ventilation systems shall be provided

with prefilters having a minimum efficiency of ............30% and final filters having a minimum efficiency of ...... 90% ii) Units thatwhich recirculate air within a room

shall be provided with filters having a minimum efficiency of .................................................................30%

iii) The exhaust from isotope storage shall be

provided with filters with 99.97% efficiency (based on the DODDOP, dioctylphthalate, test method as described in DODDOP Penetration Test Method MIL STD No. 282 (1976): Filter Units, Protective Clothing, Gas-Mask Components and Related Products: Performance Test Methods).


i) Temperature, dry bulb ................................................... 75° ii) Relative Humidity, winter, minimum ........................... 30%




iii) Relative Humidity, summer, maximum ........................ 60%

C) Air Circulation:



air supplied. D) Space Pressurization: Ventilation system shall be designed and balanced so

that space pressure, in relation to surrounding areas of the building, is ........................................................................ neutral

E) Recirculation of air within room permitted ............................ yes F) Air from the following areas shall be exhausted directly to the

outdoors:

Nuclear medicine and isotope storage. 5) Pharmacy Suite

A) Filters:


prefilters having a minimum efficiency of .................... 30% and final filters having a minimum efficiency of .......... 90% ii) Units which recirculate air within a room shall be

provided with filters having a minimum efficiency of .................................................................................. 30%


i) Temperature, dry bulb ................................................... 75°




ii) Relative Humidity, winter, minimum ........................... 30% iii) Relative Humidity, summer, maximum ........................ 60%

C) Air Circulation:



air supplied. D) Space Pressurization: Ventilation system shall be designed and balanced so that

space pressure, in relation to surrounding areas of the building, is ................................................................................ neutral

E) Recirculation of air within room permitted .............................. yes

6) Physical Therapy Suite and Hydrotherapy A) Filters:

i) Central ventilation systems shall be provided with prefilters having a minimum efficiency of .................... 30%

ii) and final filters having a minimum efficiency of .......... 90% ii)iii) Units thatwhich recirculate air within a room shall

be provided with filters having a minimum efficiency of ................................................................. 30%






C) Air Circulation:




that space pressure, in relation to surrounding areas of the building, is ...................................................................... negative

E) Recirculation of air within room permitted .......................... yes

7) Occupational Therapy Suite

A) Filters:


prefilters having a minimum efficiency of .................... 30% ii) and final filters having a minimum efficiency of .......... 90% ii)iii) Units thatwhich recirculate air within a room shall




C) Air Circulation:







that space pressure, in relation to surrounding areas of the building, is ...................................................................... neutral

E) Recirculation of air within room permitted .......................... yes

8) Nursing Units (including units such as medical, surgical, intensive care,

pediatric, psychiatric, obstetric) A) Filters:





i) Temperature, dry bulb ................................................ 75° ii) Relative Humidity, winter, minimum ........................ 30% iii) Relative Humidity, summer, maximum ..................... 60%

C) Air Circulation (Patient Rooms):

i) Total air supplied, cfm per bed ...................................15 ii) Outdoor air supplied, cfm per bed ...............................10

D) Air Circulation:




i) Total air supplied to each space shall be as required to

maintain space design conditions. ii) Outdoor air supplied shall be no less than 20% of the total

air supplied. E) Space Pressurization: Ventilation system shall be designed and balanced so

that space pressure, in relation to surrounding areas of the building, is .........................................................................neutral

F) Recirculation of air within room permitted ............................ yes G) Isolation Rooms: These rooms may be used two ways: to protect

the patient from the hospital environment or to protect the hospital environment from the patient. Isolation rooms shall have the same conditions as other patient rooms, except thatthe air flow shall be capable of being either into the room or out of the room. When the hospital is being protected (communicable disease), all air shall be exhausted directly to the outdoors.

9) Newborn Care Unit

A) Filters:





i) Temperature, dry bulb ................................................... 75° ii) Relative Humidity, winter, minimum ........................... 30%




iii) Relative Humidity, summer, maximum ........................ 60%

C) Air Circulation (Patient Rooms):

i) Total air supplied, cfm per bed ..................................... 15 ii) Outdoor air supplied, cfm per bed ................................. 10

D) Air Circulation:



air supplied. E) Space Pressurization: Ventilation system shall be designed and balanced so that


F) Recirculation of air within room permitted .............................. yes

10) Surgical Suite-Operating Rooms A) Filters:





i) Temperature, dry bulb (adjustedadj. range) ........... 70°F-76°F




ii) Relative Humidity, winter, minimum .............................. 40% iii) Relative Humidity, summer, maximum ........................... 60%

C) Air Circulation:

i) Total air supplied, air changes per hour ............................. 15 ii) Outdoor air supplied shall be no less than 20% of the

total air supplied. D) Space Pressurization: Ventilation system shall be designed and balanced so that

space pressure, in relation to surrounding areas of the building, is ............................................................................... positive

E) Recirculation of air within room permitted ............................. yes F) Minimum requirements for all other spaces within the surgical

suite shall be the same as required for Nursing Units. G) The minimum circulation rate for operating rooms shall be based

on the lowest 9 feet of room height. Air quantity shall be increased as required to meet greater loads and still maintain the desired space conditions.

H) All operating rooms shall have scavenger systems for removing

spent anesthetic gases as per NFPA Standard No. 99, Standard for Health Care Facilities.(1993), "Health Care Facilities Code."

I) Operating rooms' air supply shall be from ceiling outlets near the

center of the work area to effectively control air movement. Return air shall be not less than 3 inches nor more than 12 inches from the floor. Each operating room shall have at least two return air inlets located as remotely from each other as practical.

11) Obstetrics Suite




A) Filters: i) Central ventilation systems shall be provided with




i) Temperature, dry bulb (adjustedadj. range) ........... 70°F-76°F ii) Relative Humidity, winter, minimum ........................... 30% iii) Relative Humidity, summer, maximum ........................ 60%

C) Air Circulation:



air supplied.

iii) Space Pressurization: iv) Ventilation system shall be designed and

balanced so that space pressure, in relation to surrounding areas of the building, is .......................... neutral

D) Recirculation of air within room permitted .............................. yes E) Delivery rooms' air supply shall be from ceiling outlets near the

center of the work area to effectively control air movement. Return air shall be not less than 3 inches nor more than 12 inches from the floor. Each delivery room shall have at least two return air inlets located as remotely from each other as practical.




F) Where anesthetic gases are used, scavenger systemssystem for

removing spent anesthetics gases as per NFPA Standard No. 99, Standard for Health Care Facilities,(1993), "Health Care Facilities Code," shall be provided.

G) Delivery rooms whereWhere caesarean section is performed shall

meet the heating, ventilation, and air conditioning, the delivery room (HVAC) requirements forshall be as per operating rooms.

12) Emergency Suite

A) Filters:





i) Temperature, dry bulb ................................................... 75°F ii) Relative Humidity, winter, minimum ........................... 30% iii) Relative Humidity, summer, maximum ........................ 60%

C) Air Circulation:


ii) Outdoor air supplied shall be no less than 20% of

the total air supplied. D) Space Pressurization:




Ventilation system shall be designed and balanced so that space pressure, in relation to surrounding areas of the building, is ................................................................................ neutral

E) Recirculation of air within room permitted .............................. yes

13) Outpatient Suite

A) Filters:





i) Temperature, dry bulb ................................................... 75°F ii) Relative Humidity, winter, minimum ........................... 30% iii) Relative Humidity, summer, maximum ........................ 60%

C) Air Circulation:



the total air supplied. D) Space Pressurization: Ventilation system shall be designed and balanced so that





E) Recirculation of air within room permitted .............................. yes 14) Food Preparation Area

A) Filters:


prefilters having a minimum efficiency of ..................... 30% ii)and final filters having a minimum efficiency of ........... 90%


Temperature, dry bulb .............................................................. 75°F C) Air Circulation:



the total air supplied. D) Space Pressurization: Ventilation system shall be designed and balanced so that

space pressure, in relation to surrounding areas of the building, is ................................................................................ negative

E) Recirculation of air within room permitted .............................. no F) Dining areas adjacent to the food preparation areaMinimum

requirements for adjacent dining areas shall meetbe the requirementssame as required for Public Areas.

G) If direct make-up hoods (short cycle) are used, all outside air to the

hood shall be filtered by 30% minimum efficiency filters and shall not cause cold cooking surfaces, condensation problems, or grease build-up due to cold temperature.

H) Kitchen air exhausted from the space through hoods shallmust be

made up with outside air. Air shall flow into the kitchen to prevent




cooking odors from migrating throughout the hospital. Recirculation of air is permissible, if a central system is used that, and serves only the kitchen, cafeteria, and ware-washing area.

I) AWhen there is a dishwasher being used, it shall have a separate

exhaust that is interlocked with the dishwasher to operate only when the dishwasher operates.

J) Air supply quantity must equal or exceed air exhaust quantity or

meet the loads encountered, whichever is greater. K) During the unoccupied cycle, kitchen temperature shall be

maintained at 75ºF plus or minus 10ºF. L) The hood and duct system for cooking equipment used in

processes producing smoke or grease-laden vapors shall complybe in conformance with NFPA Standard No. 96, Standard for Ventilation Control and Fire Protection of Commercial Cooling Operations.(1991), "Vapor Removal Cooking Equipment." That portion of the fire extinguishment system required for protection of the duct system may be omitted when all cooking equipment is served by U.L. listed grease extractors. i) Other exhaust hoods in food preparation centers shall have

an exhaust rate of not less than 50 cubic feet per minuteCFM per square foot of face area. The face area is the open area from exposed perimeter of hood to the open perimeter of the cooking surface.

ii) Clean-out openings shall be provided at each change in

direction and in horizontal sections no more than 20 feet apart in the duct system serving kitchen and food preparation areas.

15) Central Sterile Supply

A) Filters:

i) Central ventilation systems shall be provided with 30%




prefilters having a minimum efficiency of .................... ii) and final filters having a minimum efficiency of .......... 90%

B) Space Design Conditions: i) Temperature, dry bulb (adjustedadj. range) .................. 75°F ii) Relative Humidity, winter, minimum ........................... 30% iii) Relative Humidity, summer, maximum ........................ 60%

C) Air Circulation:



the total air supplied.

D) Air flow shall be from the clean area toward the soiled or decontamination area.

E) Sterilization Room:

i) Where only steam autoclaves are installed, the air

exhausted from the sterilizer area for heat control may be recirculated through a central system thatwhich is provided with filters having a minimum efficiency of 90%.

ii) Where ethyleneehtylene oxide sterilizers are used, all air

contaminated with ethylene oxide above 1 part per million PPM shallmust be exhausted directly outdoors. No air shall be recirculated that has more than 1 part per millionPPM of ethylene oxide present.

16) Linen Services; Laundry

A) Filters:




i)Central ventilation systems shall be provided with prefilters having a minimum efficiency of ................... 30% ii)and final filters having a minimum efficiency of ...... 80%

B) Space Design Conditions: Temperature, dry bulb (winter) .................................................. 75°F

C) All air from the soiled storage and sorting area shall be exhausted

directly to outdoors. D) Air flow shall be from the clean area to the soiled area. Air from

the clean area may be used to make up air exhausted from the soiled area.

E) Air from the clean area may be recirculated within the laundry

complex, but shall pass through a lint screen or trap before returning to the air handling unit.

F) The entire laundry ventilation system shall be controlled so that air

flow is into the laundry from the hospitalhospitals. G) Circulation and ventilation rates may be variable, but sufficient

outside air shallmust be supplied to make up for exhaust. Minimum circulation of unconditioned air at summer design conditions shall be 2 cubic feet per minutecfm per square footft2 or 12 air changes per hour, whichever is larger.

17) Miscellaneous Supporting Areas

A) Space temperatures shall be maintained for occupant comfort. B) Ventilation systemssystem shall be designed and balanced so that

air flows into these spaces from adjacent areas. C) Anesthesia Storage Rooms:

i) All air shall be exhausted directly to the outdoors.




ii) Minimum exhaust ventilation rates shall be six air changes per hour.

iii) The ventilation system shall conform to the requirements of

NFPA Standard No. 99, Standard for Health Care Facilities (1993), "Health Care Facilities Code," including the option to provide a gravity (non-mechanical) ventilation system.

iv) Supply air makeupmake-up for exhaust requirements may

be provided from a mechanical ventilation system or by transfer from adjacent areas.

D) Soiled Holding and Work Rooms:

i) All air shall be exhausted directly to the outdoors. ii) Minimum exhaust ventilation rates shall be 10 air changes

per hour. iii) Supply air makeupmake-up for exhaust requirements may


E) Toilet Rooms and Bathrooms:

i) Exhaust air may be recirculated through a central

ventilation system that is provided with final filters having a minimum efficiency of 90%. Otherwise, all air shall be exhausted directly to the outdoors.

ii) Minimum exhaust ventilation rate shall be 1.5 cubic feet

per minutecfm per square foot of floor area, but no less than 50 cubic feet per minutecfm.

iii) Supply air makeupmake-up for exhaust requirements may


F) Janitor Closets, Linen, and Trash Chute Rooms:




i) All air shall be exhausted directly to the outdoors. ii) Minimum exhaust ventilation rate shall be 1.5 cubic feet

per minutecfm per square foot of floor area, but no less than 50 cubic feet per minutecfm.

iii) Supply air makeupmake-up for exhaust requirements may


G) Boiler rooms shall be provided with sufficient outdoor air to

maintain combustion rates of equipment and limit temperatures in working stations to 97°F effective temperature (97°F and 50% relative humidity or its equivalent) as defined by ASHRAE Handbook of Fundamentals (1981).

H) Rooms containing heat-producing equipment, such as boiler

rooms, heater rooms, food preparation centers, laundries, sterilizer rooms, or mechanical equipment rooms, shall be insulated and ventilated to prevent any floor surface above from exceeding a temperature of 100°F.


Section 250.2490 Plumbing and Other Piping Systems

a) General All plumbing systems shall be designed and installed in accordance with the

requirements of the Illinois State Plumbing Code, except that the number of waterclosets, urinals, lavatories, bathtubs, showers, drinking fountains, and other fixtures shall be as required by this Part and the hospital programs.

b) Plumbing Fixtures

1) Plumbing fixtures shall be of nonabsorptive acid-resistant materials. 2) The water supply spout for lavatories and sinks required for filling

pitchers and, for medical and nursing staff and food handlers' hand-




washing handwashing, shall be mounted so that its discharge point hasis a minimum perpendicular distance of 5 inches above the rim of the fixture.

3) Hand-washingHandwashing lavatories used by medical and nursing staff

and food handlers shall be trimmed with valves thatwhich can be operated without the use of hands where specifically required in this Partprevious sections. A) When blade handles are used, for this purpose the blade handles

shall not exceed 4½ inches in length, except that the handles on clinical sinks shall not be less than 6 inches in length.

B) The hand-washinghandwashing and/or scrub sinks, for operating,

emergency treatment, nursery, and deliveryOperating, Emergency Treatment, Nursery, and Delivery rooms shall be trimmed with valves thatwhich are asepticallyasceptically operated (i.e., knee or foot controls) without the use of hands. Wrist blades are not acceptable.

4) Clinical rim flush sinks shall have an integral trap in which the upper

portion of a visible trap seal provides a water surface. 5) Shower bases and tubs shall be provided with nonslip surfaces.

c) Water Supply Systems

1) Systems shall be designed to supply water at sufficient pressure to operate

all fixtures and equipment during maximum demand periods. 2) Each water service main, branch main, riser and branch to a group of

fixtures shall be valved. Stop valves shall be provided at each fixture. 3) Flush valves installed on plumbing fixtures shall be of a quiet operating

type, equipped with silencers. 4) Bedpan-flushing devices shall be provided on each patient toilet unless a

clinical service sink is centrally located in each nursing unit. This requirement does not apply to psychiatric units.




5) Water distribution systems shall be arranged to provide hot water at each hot water outlet at all times. Hot water at shower, bathing, and hand-washinghandwashing facilities shall not exceed 110º F (43º C). If the program requires, in psychiatric units, plumbing fixtures thatwhich require hot water and are accessible to patients shall be supplied with hot water not to exceed 100º F (38º C).

d) Hot Water Heaters and Tanks

1) The hot water heating equipment shall have sufficient capacity to supply

water at the temperatures and quantities in the following areas:

Clinical Dietary Laundry

gallons/hour/bed 6½ 4 4½ liters/second/bed .007 .004 .005 temperature ºF 100 180 180 temperature ºC 43 82 82

Water temperatures are to be taken at the hot water point of use or at the inlet to the processing equipment.

2) Storage tanks shall be fabricated of corrosion-resistant metal or lined with

non-corrosive material. e) Drainage Systems

1) Drain lines from sinks in which acid wastes may be poured shall be

constructed offabricated from acid-resistant material. 2) Insofar as possible, drain piping shall not be installed over operating and

delivery rooms;, nurseries;, food preparation, serving, and storage areas; and similar critical areas. Special precautions shall be taken to protect these areas from possible leakage or condensation from such overhead piping systems.

3) Floor drains shall not be installed in operating rooms. Flushing rim type

drains may be installed in cytoscopic operating roomsCystoscopic Operating Rooms.




4) Building sewers shall discharge into a public sewersewerage system. 5) WhenWhere a public sewersewerage system is not available, plans for any

private sewage disposal system shall be submitted to the Environmental Protection Agency of Illinois for review for approval before hospital construction is started.

f) Nonflammable medical gas systems shall be installed in accordance with NFPA

Standard No.99, Standard for Health Care Facilities.(1993), "Health Care Facilities Code."

g) Clinical vacuum (suction) systems shall be installed in accordance with NFPA 99,

Standard for Health Care Facilities.Compressed Gas Association Pamphlet P-2.1 (1970), "Standard for Medical-Surgical Vacuum Systems in Hospitals."

h) Medical compressed air systems shall be installed in accordance with NFPA 99,

Standard for Health Care Facilities.Compressed Gas Association Pamphlet P-2.1. i) Oxygen, vacuum, and medical compressed air shall be piped to the locations

indicated in Section 250.Table E with the required station outlets. j) Service outlets for central housekeeping vacuum systems, if used, shall not be

located within operating rooms. k) Fire Extinguishing Systems

1) All fire extinguishing systems shall be designed, installed, and maintained

in accordance with NFPA Standard No.101, (1994), "Life Safety Code," NFPA Standard No. 13, Standards for the Installation of Sprinkler Systems,(1994), "Sprinkler Systems," and NFPA Standard No.2513A, Standard for the Inspection, Testing, and Maintenance of Water-Based Fire Protection Systems.(1987), "Sprinkler System Maintenance."

2) Class III, Type 1 inside standpipe systemssystem shall be provided in all

buildings more than four stories or 55 feet in height. Such standpipe systems shall comply withconform to the requirements of NFPA Standard No.14, Standard for the Installation of Standpipe, Private Hydrants and Hose Systems.(1980), "Standpipe and Hose Systems."




(Source: Amended at 35 Ill. Reg. ______, effective ____________) Section 250.2500 Electrical Requirements

a) General 1) All materials, including equipment, conductors, controls, and signaling

devices, shall be installed in compliance with applicable sections of the NFPA Standard No.70,: (1993), "National Electric Code," including Article 517, and as necessary to provide a complete electrical system.

2) All electrical installations, including alarm, nurses' call, and

communication systems, shall be tested to demonstrate that the equipment installation and operation conformconforms to these requirements.

b) Switchboards and Power Panels These items shall comply with NFPA Standard No.70, (1993), "National

Electrical Code." The main switchboard shall be located in an area separate from plumbing and mechanical equipment and be accessible only to authorized persons.

c) Panelboards. Panelboards serving lighting and appliance circuits shall be located

on the same floor as the circuits they serve. This requirement does not apply to the life safety system.

d) Lighting

1) All spaces occupied by people, machinery, and equipment within

buildings, approaches to and through exits from buildings, and parking lots shall have lighting.

2) Patients' rooms shall be equipped with general lighting and night lighting.

A reading light shall be provided for each patient. At least one light fixture for night lighting shall be switched at the entrance to each patient room. All switches for control of lighting in patient areas shall be of the quiet operating type.

3) Operating and delivery rooms shall have general lighting in addition to

local lighting provided by special lighting units at the surgical and




obstetrical tables. The general lighting shall provide a minimum of 100 footcandles at the procedure tables. Each fixed special lighting unit at the tables shall be connected to an independent circuit.

e) Receptacles (Convenience Outlets)

1) Each operating and delivery roomOperating and Delivery Room shall

have at least two receptacles installed on each wall or eight receptacles in diversified locations per room.

2) Each patient room shall have duplex grounding type receptacles as

specified in Article 517-83 and Article 517-84 of the National Electrical Code. The mounting height of these receptacles shall be 22 to 42 inches above the finished floor.

3) Duplex receptacles for general use shall be installed approximately 50

feet50'0" apart in all corridors and within 25 feet25'0" of the ends of corridors. These receptacles shall be circuited to the emergency system. Single polarized receptacles marked for use of X-ray only shall be located in corridors of patient areas so that mobile equipment may be used in any location within a patient room without exceeding a cord length of 50 feet50'0" attached to the equipment. If the same mobile X-ray unit is used in operating rooms and in nursing areas, all receptacles for X-ray use shall be of a configuration that one plug will fit the receptacles in all locations. Where capacitive discharge or battery-powered X-ray units are used, these polarized receptacles are not required.

f) At least two X-rayx-ray film illuminators shall be installed in each operating,

delivery, and recovery room, emergency treatment areasOperating, Delivery and Recovery Room, Emergency Treatment Area(s), and in the X-ray Viewing Room of the radiology departmentRadiology Department. More than two units shall be installed as needed.

g) Nurses' Calling System

1) Each patient room shall be served by at least one calling station and each

bed shall be provided with a call button. Two call buttons serving adjacent beds may be served by one calling station. Calls shall register with nursing staff and shall actuate a visible signal in the corridor at the




patients' door. In multicorridor nursing units, additional visible signals shall be installed at corridor intersections. In rooms containing two or more calling stations, indicating lights shall be provided at each station. Nurses' calling systems thatCalling Systems which provide two-way voice communications shall be equipped with an indicating light at each calling station, which will remain lighted as long as the voice circuit is operating.

2) Nurse call duty stations shall be installed in the clean work room, soiled

work room, medicine preparation room, nourishment station, and nurses' lounge of the unit.

3) A nurses' call emergency stationNurses' Call Emergency Station shall be

provided for patients' use at each patient's toilet, bath, sitz bath, and shower. These stations are to be the pull-cord type with the cord reaching within 6 inches of the floor. The cords shallare to be located within reach of a patient.

4) In areas such as intensive care, cardiac care, recovery and similar patient

care areas where patients are under constant surveillance, the nurses' calling systemNurses' Calling System may be limited to a bedside station that will actuate a signal that can be readily seen by the other nurses.

5) A communications system thatwhich may be used by nurses to summon

assistance shall be provided in each operating, delivery, special procedure, birthing, recovery, emergency treatment, and critical care room; in nurseries; and in nursing units for psychiatric patientsOperating, Delivery, Special Procedure, Birthing, Recovery, Emergency Treatment, Critical Care Rooms, in Nurseries, and in Nursing Units for Psychiatric Patients.

h) Communication System

1) A loudspeaker-loud speaker type sound system shall be provided

throughout the facility to allow for announcements, such as the paging of personnel and other necessary audio functions.

2) Speakers shall be located in all departments to allow hospital personnel to

adequately hear all audio outputs from the system. 3) The system shall be used as the communication link for emergency




announcements, i.e., code blue, impending disasters and others. The audio line at the last speaker in the audio circuits shall be electrically supervised against opens and grounds. The supervision shall be indicated at a building location thatwhich is staffed 24 hours a day.

i) Emergency Electric Service

1) To provide electricity during an interruption of the normal electric supply,

an emergency source of electricity shall be provided and connected to the life safety branch, the critical branch, and the equipment branch for lighting and power as established in NFPA 70, National Electrical Code.

2) The source of this emergency electric service shall be as follows:

A) An emergency generating set when the normal service is supplied

by one or more central station transmission lines. B) An emergency generating set or a central station transmission line

when the normal electric supply is generated on the premises. 3) Emergency Generating Set

A) The required emergency generating set, including the prime mover

and generator, shall be located on the premises. Where stored fuel is required for the emergency generator operations, the storage capacity shall be sufficient for not less than 24-hours of continuous operation.

B) The emergency generator set may be used during periods of high

energy demands on local utilities. In the event of an outage of the normal power source, the normal loads shall immediately be removed from the emergency generating set, and the life safety branch, the critical branch, and the equipment branch shall be connected to the generator.


SUBPART U: CONSTRUCTION REQUIREMENTSSTANDARDS FOR EXISTING

HOSPITALS




Section 250.2610 Applicability of Subpart Uthese Standards

a) Subpart UThese Standards shall apply to all existing hospitals and to minor alterations to existing hospitals. Plans need not be submitted for alterations or remodeling changes thatwhich do not affect the structural integrity of the building, thatwhich do not change functional operation, thatwhich do not affect fire safety, and thatwhich do not add beds or facilities more thanover those for which the hospital is licensed. See Subpart T for new construction and major additions and alteration requirements.

b) In the cases of types of hospitals not specifically treated in this Subpartherein, the

standards for general hospitals shall apply, with due allowance being made for the specialized or unusual requirements of the particular hospital involved.

c) PrioritiesThe establishment of priorities, phasing schedules, and dates of

completion based upon the urgency of correction, the required completion time, and financial capabilities, shall be established as agreed by the Department and each facility.


Section 250.2620 Codes and Standards

a) The National Fire Protection Association (NFPA) Standard No. 101, (2000): Life Safety Code, for existing structures and all appropriate references under Appendix B applies to and is part of this Subpartthese standards.

b) The National Fire Protection Association (NFPA ) Standard No.101 A, (2001):

Guide on Alternative Approaches to Life Safety, applies to and is part of this Subpartthese standards.

c) All existing hospitals of any height shall be Type I or Type II construction as

established by NFPA 101, Life Safety Code, (2000) and NFPA 220, Standard on Types of Building Construction(1999).


Section 250.2630 Existing General Hospital RequirementsStandards




Minimum requirements in the existing General Hospital are:

a) Administration and Public Areas 1) Lobby: AIt shall include: a reception and information counter or desk, waiting

spacesspace(s), and access to public toilet facilities, public telephones, and drinking fountainsfountains(s).

2) Interview SpacesSpace(s): Spaces for private interviews relating to social service, credit, or

admissions. 3) General or Individual Officesindividual office(s): OfficesOffice(s) for business transactions, medical and financial records,

and administrative and professional staffs. 4) Multipurpose Roomsroom(s): For conferences, meetings, and education purposes. 5) Medical Library Facilitiesfacilities. 6) Storage Areas.

b) Medical Records Unit SpaceProvide adequate space for reviewing, dictating, sorting, recording, and

storing of medical records. c) Adjunct Diagnostic and Treatment

1) Laboratory Suite. Laboratory facilities shallshould be provided to meet the workload. These

may be provided within the hospitalHospital or through an effective contract arrangement with a nearby laboratory service. If laboratory services are provided by contractual arrangement, then at least the following minimum services shall be available within the hospitalHospital. (For additional requirements, see Subpart E of this Part.):.




A) Laboratory work counterscounter(s) with appropriate services. B) LavatoriesLavatory(ies) or counter sinkssink(s) equipped for hand

washinghandwashing. C) Storage cabinetscabinet(s) or closetscloset(s). D) Blood storage facilities. E) Specimen and sample collection facilities. Urine collection rooms

with nearby water closet and lavatory. Blood collection facilities with space for a chair and work counter.

2) Morgue and Autopsy Suite.

A) These facilities shall be accessible to an outside entrance and shall

be located to avoid movement of bodies through public areas wherever possible.

B) The following shall be provided when autopsies are performed

within the hospitalHospital: i) Refrigerated facilities for body holding. ii) Autopsy room: This room shall contain a work counter with sink equipped

for hand washinghandwashing; storage space for supplies, equipment, and specimens; and an autopsy table.

C) If no autopsies are performed in the hospitalHospital, a well-

ventilated body-holding room shall be provided. 3) Radiology Suite.

A) Facilities shall be provided for radiology purposes. (For additional

requirements see Subpart F of this Part.).




B) The suite shall contain the following elements: i) Radiographic roomsroom(s). ii) Film-processing facilities. iii) Viewing and administration areasarea(s). iv) Film storage facilities. v) Toilet and hand-washinghandwashing facilities accessible

from each fluoroscopy room. vi) Dressing areasarea(s) with access to toilets, and facilities

for patients'patient's belongings. vii) Waiting room or alcove. viii) X-ray installations for fixed and mobile X-rayx-ray

equipment and radiation protection, which will be checked by the Illinois Emergency Management AgencyDepartment of Nuclear Safety.

4) Pharmacy Suite.

A) The size and type of services to be provided in the pharmacy will

depend upon the type of drug distribution system used in the Hospital and whether the hospital provides, purchases, or shares pharmacy services with other hospitals or other medical facilities. (For additional requirements see Subpart R of this Part.).

B) TheProvisions shall be made for the following shall be provided:

i) Area for administrative functions, includingAdministrative

Functions. These include requisitioning, recording and reporting, receiving, storage (including refrigeration), and accounting.

ii) Quality control areaControl Area. (If bulk compounding




and/or packaging functions are performed.) iii) Locked storageStorage for drugsDrugs and

biologicalsBiologicals. iv) Dispensing areaArea. v) Hand-washing facilitiesHandwashing Facilities. vi) A drug informationDrug Information area for reference

materials and personnel. vii) If I.V. admixtures and other sterile dosage forms are

compounded, a sterile products area shallSterile Products Area must be provided with a separate sink for hand washinghandwashing.

5) Physical Therapy Suite.

A) Appropriate services may be arranged for shared use by

occupational therapy patients and staff. B) If a physical therapy suite exists, the following shall be provided:

i) Office spaceSpace(s). ii) Waiting spaceSpace. iii) Treatment areasarea(s) for such modalities as

thermotherapy, diathermy, ultrasonics, hydrotherapy and exercise. Provide visual privacy for each individual treatment area. Provide handwashing facility(ies). Provide one lavatory or sink in the suite.

iv) Visual privacy for each individual treatment center. v) Hand-washing facilities. vi) One lavatory or sink in the suite




vii)iv) Facilities for collection of wet and soiled linen and other

material shall be provided. viii)v) Storage for clean linen, supplies, and equipment. ix)vi) Patients' dressing areas and toilet facilities. x)vii) Access to and storage for wheelchairs and stretchers. xiviii) Showers, lockers, and service sinks shall be provided as

required by the service rendered. 6) Occupational Therapy Suite.

A) Appropriate elements may be arranged for shared use by physical

therapy patients and staff. B) If an occupational therapy suite exists, the following elements shall

be provided: i) Office spacesspace(s). ii) Activities areasarea(s) equipped with a sink or lavatory. iii) Storage for supplies and equipment. iv) Access to patients' toilet facilities.

d) Nursing Unit The requirements in this subsection (d) do not apply to special care areas such as

recovery rooms and intensive care areas, and newborn care areas. 1) Patient Rooms.

A) Each patient room shall be an outside room. Each patient room

shall connectcommunicate directly with an exiting corridor. B) Minimum room areas shall be: 80 square feet per bed in multi-bed




rooms, and 100 square feet in one-bed rooms (square footage to exclude closets, storage cabinets, bathrooms, and door swings). In addition, a minimum of 3 feet3'-0" must be maintained between the sides and foot of any bed and any wall or other fixed device.

C) Existing room(s) with a capacity of more than four beds on the

date of the promulgation of these regulations may be continued in use.

C)D) Each patient room shall have access to a bathroom that includes a

toilet and a sinktoilet room. ToiletsWater closets shall be provided at the rate of one per each eight beds.

D)E) The bathroomtoilet room shall contain a toiletwater closet and a

lavatory. The lavatory may be omitted from a bathroomtoilet room thatwhich serves not more than two adjacent bedrooms if each adjacent bedroom contains a lavatory.

E)F) Each patient shall have a wardrobe, locker, or closet that is suitable

for hanging and storing personal effects. F)G) Visual privacy shall be provided to each patient bed in multi-bed

rooms. G)H) At least one tub or shower shall be provided for each 30 beds

thatwhich do not have bathing facilities within the patients' rooms. Each tub or shower shall be in an enclosure thatwhich provides space for the private use of the bathing fixture and for drying and dressing.

2) Nurses' stationNurses Station and related facilities. A nurses'Provide a

nurses station with a work counter, storage areas, and communications equipment shall be provided. The following shall also be providedAlso provide: A) A drug distribution station. B) Hand-washingHandwashing facilities convenient to both the

nurses'nurses station and the drug distribution station.




C) Charting facilities for nurses and doctors. D) Accessibility to a treatment room for multi-bed room units. This

room shall contain a lavatory, work counter, storage facilities, and a writing space.

3) Service Areas.

A) A clean work area or a clean holding area shall be provided in each

nursing unit. The clean workroom shall contain a work surface, hand-washing faciliteshandwashing facility(ies), and storage facilities. The clean holding area shall be part of a system for the storage and distribution of clean and sterile supplies and materials.

B) AProvide a separate designated area for clean linen storage shall be

provided. If a cart system is used, the storage of the cart may be stored in an alcove. This function may be in a clean work area.

C) ParkingProvide parking for stretchers and wheelchairs shall be

provided out of the path of normal traffic. D) A soiled workroom or soiled holding room shall be provided. The

soiled workroom shall contain a clinical sink or equivalent flushing rim fixture, a hand-washinghandwashing sink, a waste receptacle, and a linen receptacle. The soiled holding room shall be part of a system for the collection and disposal of soiled materials. If bedpan flushing attachments are used on every patient room toilet, a clinical sink is not required in the soiled workroom.

E) Space shall be providedProvide room for the storage of equipment

such as I.V. stands, inhalators, and walkers. F) Space shall be provided for the storage of required emergency

equipment such as a crash cart. This equipment shall be under the direct control of the nursing staff.

G) A station with a sink equipped for hand washing, equipment for

serving nourishment between scheduled meals, a refrigerator,




storage cabinets, and units to provide ice for patients shall be provided.Provisions for serving nourishment between scheduled meals.

4) Isolation RoomsRoom(s). AtThere shall be at least one room shall be provided for the isolation of

patients with known or suspected communicable diesasesdisease(s). Each such room shall have an individual toilet and a lavatory. All isolation rooms shall meet requirementsbe otherwise planned as required for a standard patient room.

5) RoomsRoom(s) for PsychiatricDisturbed Patients. Every hospital thatwhich does not have a psychiatric nursing unit shall

provide facilities for the care of psychiatricdisturbed patients, usually for less than 72seventy-two hours duration. The design shall provide for close observation, and shall minimize the dangers of patient escape, suicide, or injury. CareThis may be provided in a special care room used for multiple purposes. This room may be located either in the emergency unitEmergency Unit or in a medical nursing unitMedical Nursing Unit, or in another similar location.

e) Intensive Care Units Intensive care units shall provide the following:

1) Patient Rooms. Cardiac intensive care, medical intensive care, and surgical intensive care

patients may be housed in either single-bed rooms or multi-bed rooms. Patient rooms shall meet the following requirements: A) Clearance between beds shall be not less than 6 feet6'-0". A

minimum of 3 feet3'-0" between the sides of bed and wall shall be provided. Single-bed rooms shall have a minimum of 100 square feet in area and a minimum dimension of 10 feet10'-0".

B) A lavatory equipped for hand washinghandwashing shall be

provided in each intensive care unit. C) A nurses' calling system (see Section 250.2500(g)) shall be

provided.




D) Cardiac intensive care patients shall be provided with a toilet

facility thatwhich is directly accessible from the bed area. E) Each patient shall be visible from outside the room.

2) Service Areas The following service areas shall be located in or readily available to each

intensive care unit. One area may serve two or more adjacent intensive care units. The size and location of each service area shallwill depend upon the number of beds to be served. A) Nurses' station. B) Hand-washingHandwashing facilities. These shall be convenient

to the nurses' station and the drug distribution station. C) Charting facilities with work counterscounter(s). D) Staff toilet room. A room containing a toiletwater closet and a

lavatory equipped for hand-washinghandwashing shall be accessible to the staff.

E) Clean workroom (or a system for storage and distribution of clean

and sterile supply materials). The clean workroom shall contain a work surface, hand-washinghandwashing facility, and storage facilities.

F) A readily accessible soiled workroom or soiled holding room. The

soiled workroom shall contain a clinical sink or equivalent flushing rim fixture, sink equipped for hand washinghandwashing, work surface, waste receptacle, and linen receptacle. A soiled holding room shall be part of a system for collection and disposal of soiled materials and shall be similar to the soiled workroom except that the clinical sink and work counter may be omitted.

G) A drugDrug distribution station shall be provided. Provision shall

be made for convenient and prompt 24-hour distribution of medicine to patients.




H) AClean linen storage. Provide a storage closet or a designated area

within the clean workroom shall be provided for clean linen storage. If a closed cart system is used, the cartstorage may be stored in an alcove.

I) A station with sink equipped for hand washing, equipment for

serving nourishment between scheduled meals, a refrigerator, storage cabinets, and units to provide ice for patients shall be provided.Provisions for nourishment.

J) Emergency equipment storage. Designated space shall be provided

for a "crash cart" and similar emergency equipment. K) Space shall be provided for equipmentEquipment storage. Provide

space for necessary equipment. 3) Waiting Area: A waiting area shall be provided for family members and others who may

be permitted to visit the intensive care patients. A toilet room and public telephone shall be available.

f) Pediatric Nursing Unit If a separate unit is provided it shall meet the following requirements:

1) General unit requirements,Unit Requirements including patient

roomsPatient Rooms. The requirements noted in Section 250.2630(d) shall be applied to a

pediatric and adolescent nursing unit containing hospital beds. Adequate spaces shall be provided for youth beds and cribs.

2) Nursery Each nursery serving pediatric patients shall contain no more than 12

bassinets. The minimum clear floor area per bassinet shall be 40 square feet. Each room shall contain a lavatory equipped for hand washinghandwashing, nurses' emergency calling system and glazed viewing windows for observing infants from public areas and the workroom.




3) Nursery Workrooms. Each nursery shall be served by a connecting workroom. One workroom

may serve more than one nursery. 4) Examination and Treatment Room. The examination and treatment roomIt shall contain a work surface,

storage facilities, and a lavatory equipped for hand washinghandwashing. 5) Service Areas. The service areas in the pediatric and adolescent nursing unit shall comply

withconform to the conditions listed in Section 250.2630(d)(3) and shall meet the following additional conditions: A) Multipurpose or individual areas shall be provided for dining,

educational, and play or other patient care purposes. B) Space for storage of infant formula shall be provided in the unit or

in a convenient location nearby. C) Patients' toilet roomsroom(s) shall be provided. D) Storage closets or cabinets for toys and for educational and

recreational equipment shall be provided. E) Storage space shall be provided for replacement of youth and adult

beds to provide flexibility for interchange of patient accommodations. This storage space need(Need not be located in the Pediatric Nursing Unit.)

6) Fixtures and Accessories.

A) Attention shall be given to other details affecting small children as

required by the program. B) Switches and electrical outlets for critical equipment shall be

protected to preclude shock and/or located for inaccessibility by small children.

g) Psychiatric Nursing Unit




1) Nursing unitsUnits intended for psychiatric or other types of patients

needing close supervisiondisturbed patient nursing care shall provide a safe and secure facility for patients needing close supervision to minimize patients'their hiding, escape, injury, or suicide. The unit shall allow care of ambulatory inpatients, to permit flexibility in arranging various types of therapy, and shallshould present as noninstitutional an atmosphere as possible.

2) Each psychiatric nursing unit shall provide the following:

A) Patient Rooms. The requirements noted in Section 250.2630(d) shall be applied to

patient rooms in psychiatric nursing units except as follows: i) A nurses' calling system is not required. Other types of

communications systems may be utilized. ii) ProvisionsProvision for visual privacy areis not required. iii) Three feet of clearance3'-0" clear at the foot and sides of

each bed is not required. B) Service Areas. The service areas noted in Section 250.2630(d)(3) shall be

provided or made available to each psychiatric nursing unit, except that space for stretchers and wheelchairs is not required, and clinical sinks or equivalent may be installed but are not required. The following elements shall be provided within and for the exclusive use of the unit: i) Consultation roomsroom(s). ii) Space for dining, recreation, and occupational therapy. iii) Storage closets or cabinets for recreational and

occupational therapy equipment. h) Newborn Care Unit




Newborn infants shall be housed in nurseries thatwhich are conveniently located to the postpartum nursing unit and obstetrical facilities. The nurseries shall be located and arranged to preclude unrelated traffic. Subpart O of this Part, in its entirety,these Requirements shall apply to the newborn care unitthis section in its entirety. The units shall meet the following requirements: 1) General. Each nursery shall contain:

A) At least one lavatory trimmed with valves thatwhich are aseptically

operated (i.e., knee or foot controls). B) A nurses' emergency calling system. C) Bassinets shall be provided in a number at least equal to the

number of postpartum beds. D) GlazedProvide glazed observation windows to permit viewing

infants from public areas and from workrooms. 2) Full-Term Nursery. The full-term nurseryIt shall contain no more than 12 bassinets; however,

this number may be increased to 16 if the extra bassinets are of the isolation type. The minimum floor area shall be 30 square feet for each regular bassinet and 40 square feet for each isolation type bassinet. When a "rooming-in" program is used, the total number of bassinets provided in these units may be appropriately reduced, but the full-term nursery may not be omitted.

3) Special Care and Observation Nursery. If a separate special care and observation nursery is provided, it shall have

its own work area, and at least 40 square feet per bassinet shall be provided in the nursery.

4) WorkroomWork Room. Each nursery shall be served by a connecting workroom. The workroomIt

shall contain gowning facilities at the entrance for staff and housekeeping personnel, work space with a counter, a refrigerator, a lavatory or sink equipped for hand washinghandwashing, and storage. One workroom may serve more than one nursery. The workroom thatwhich serves the




special care nursery may be omitted if equivalent work area and facilities are provided within the nursery in which case the gowning facilities shall be located near the entrance to the nursery and shall be separated from the work area.

5) Examination and Treatment Room or Space for Infants. The examination or treatment room or spaceIt shall contain a work

counter, storage, and a lavatory equipped for hand washinghandwashing trimmed with valves thatwhich are aseptically operated (i.e., knee or foot controls). The room or spaceIt may serve more than one nursery and may be located in the workroom. If the examination and treatment of infants will take place in the individual bassinets, space for physicians' and nurses' gowning shall be provided as well as a conveniently accessible hand-washinghandwashing sink trimmed with valves thatwhich are aseptically operated (i.e., knee or foot controls).

6) Infant Formula Facilities. The hospital shall provide one of the following:

A) On-site formula preparation.

i) Clean-up facilities for washing and sterilizing supplies.

These shall consist of a lavatory or sink equipped for hand washinghandwashing, a bottle washer, work counter space, and an equipment sterilizer.

ii) A separate room for preparing infant formula, which. It

shall contain a lavatory or sink equipped for hand washinghandwashing, a refrigerator, a work counter, a formula sterilizer, and storage facilities. The roomIt may be located near the nurseries or at another appropriate place within the hospital. No direct access from the formula room to a nursery or to a nursery workroom shallwill be permitted.

B) Commercially prepared formula.

If a commercial infant formula is used, the storage and handling may be done in the nursery workroom or in another appropriate room thatwhich has a work counter, a sink equipped for hand




washinghandwashing, and storage facilities. 7) Janitors' Closet A closet shall be provided for the exclusive use of the housekeeping staff

in maintaining the nursery unit shall be provided. The closetIt shall contain a floor receptor or service sink and storage space for housekeeping equipment and supplies.

8) Storage spacesspace(s) for replacement bassinets, phototherapy units, and

other large items shall be provided. These storage areasarea(s) may be located either within the unit or in the central supplies storage.

i) Surgical Suite The number of operating rooms and recovery beds and the sizes of the service

areas shall be based on the expected surgical workload. The surgical suite shall be located and arranged to preclude unrelated traffic through the suite. The requirements of Section 250.1820(h) shall be used for the surgical suite wherever applicable. The suite shall provide the following elements: 1) General Operating RoomsRoom(s). Each room shall have a minimum clear area of 300 square feet exclusive

of fixed cabinets and shelves. The minimum dimension shall be 15 feet15'-0". AProvide a communications system connecting with the surgical suite control station shall be provided. AtProvide at least two X-rayx-ray film illuminators shall be provided in each room.

2) Fracture Rooms. Fracture rooms shallshould be provided with accessible splint facilities.

The fracture room may be located in the emergency department, the surgical suite, or in another similar location.

3) Recovery Room. The recovery room may be part of an approved combined surgical-

obstetrical program (see Section 250.1820(h)). A) TheLocate the postoperative recovery room shall be located within

or adjacent to the surgical suite. If possible, provide separate entrance and exit doors remote from each other shall be provided to facilitate a one-way traffic flow within the recovery room.




B) AThere shall be a minimum of one recovery room bed shall be

provided for each operating room. C) AThere shall be a minimum of 70 square feet per bed shall be

provided in open units. This area shall exclude the nurses'nursing station, work space, and storage area. In addition, a minimum of 4 feet shall4'-0" must be maintained between the sides of the beds, at least 3 feet3'-0" between the side of any bed and any wall or other fixed device, and at least 6 feet6'-0" between the foot end of any bed and any other fixed equipment or device.

D) The recovery room shall have adequate lighting of the type to

allow accurate observation of the patients. E) AThere shall be a lavatory shall be provided, trimmed with valves

that are operated without the use of hands. A clinical sink shall be providedaccessible.

F) A soiled holding area shall be provided. G) A nurses'There shall be a nursing station shall be provided within

the postoperative recovery room. Facilities for medical storage and preparation shall be provided.

H) Adequate storage and work space within or adjacent to the

recovery room shall be available for necessary supplies and equipment.

I) Each bed site shall be adequately equipped with oxygen, suction,

and at least one duplex electrical outlet. J) Where ambulatory surgery is performed using local anesthetics in

the surgery suite, a room separate from the general recovery room shall be set aside for the patients'patient's recovery.

4) Service Areas. Individual roomsroom shall be provided when so noted; otherwise alcoves

or other open spaces thatwhich will not interfere with traffic may be used.




Services may be shared with and organized as part of the obstetrical facilities if the approved narrative program reflects this sharing concept. There shall be no crosscirculation between the surgical and delivery suites when using shared service areas. The following services shall be provided: A) Control station to permit surveillance of all traffic thatwhich enters

the operating suite. B) Supervisor'sSupervisors office or station, which (may be part of

the control station). C) Sterilizing facilitiesfacility(ies) with high speed autoclaves

conveniently located to serve all operating rooms. If adequate provisions have been made for the replacement of sterile instruments during surgery, sterilizing facilities in the surgical suite will not be required.

D) Drug distribution station. Provision shall be made for the

preparation of medication to be administered to patients. E) Scrub facilities shall be conveniently located near each operating

room, and shall be arranged to minimize any incidental splatter on nearby personnel or supply carts. Scrub sinks,Provide scrub sink(s) which shallmay be aseptically operated without the use of hands, shall be provided. (Wrist blades are not acceptable.)

F) Soiled workroom or a soiled holding room that is part of a system

for the collection and disposal of soiled materials. The soiled workroom shall contain a clinical sink or equivalent flushing type fixture, a work surface, sink equipped for hand washinghandwashing, a waste receptacle, and a linen receptacle. A soiled holding room shall be similar to the soiled workroom except that the clinical sink and work counter may be omitted.

G) Fluid waste disposal facilities,. These shall be conveniently

located with respect to the general operating rooms. A clinical sink or equivalent equipment in a soiled workroom or in a soiled holding room would meet this requirement.




H) Clean workroom or a clean supply room. A clean workroom is

required when clean materials are assembled within the surgical suite prior to use. A clean workroom shall contain a work surface, sink equipped for hand washinghandwashing, and space for clean and sterile supplies. A clean supply room shall be provided when thea system is used for the storage and distribution of clean and sterile supplies which does not require the use of a clean workroom.

I) Anesthesia storage facilities. Unless official hospital governing

board action prohibits in writing the use of flammable anesthetics, a separate room shall be provided for storage of flammable gases in accordance with the requirements of NFPA 99, Standard for Health Care Facilities.detailed in The National Fire Protection Association Standards 56A (Inhalation Anesthetics) and 56F (Nonflammable Medical Gases).

J) Anesthesia work area for cleaning, testing, and storing anesthesia

equipment, which. It shall contain a work counter and sink. K) Medical gas storage. Space for reserve storage of nitrous oxide

and oxygen cylinders shall be provided. L) Storage area for splints and traction equipment shall be provided

for operating rooms equipped for orthopedic surgery. M) Equipment storage areasarea(s) for equipment and supplies used in

the surgical suite. N) Staff clothing change areas. Appropriate areas shall be provided

for male and female personnel (orderlies, technicians, nurses, and doctors) working within the surgical suite. The areas shall contain lockers, showers, toilets, lavatories, and space for donning scrub suits and boots.

O) Outpatient surgery change areas. If the program requires

outpatient surgery, a separate area shall be provided where outpatients change from street clothing into hospital gowns and are




prepared for surgery. This area shall include a waiting room, lockers, toilets, and clothing change or gowning area.

P) Patients' holding area. In facilities with two or more operating

rooms, space shall be provided to accommodate stretcher patients waiting for surgery.

Q) Stretcher storage area. R) Janitors' closet. A closet containing a floor receptor or service sink

and storage space for housekeeping supplies and equipment shall be provided exclusively for the surgical suite.

5) Central Sterilizing and Supply Room.

A) The central sterile supplies area shall be located either within the surgical suite or provided as a separate department within the hospital. The following shall be provided:

i)A) A receiving and clean-up room containing work space and

equipment for cleaning medical and surgical equipment, and for disposal or processing of unclean material. Hand washingHandwashing facilities operated without the use of hands shall be provided.

ii)B) A clean workroom containing work space and equipment

for sterilizing medical and surgical equipment and supplies.

iii)C) Storage areas for clean supplies and for sterile supplies (these may be in the clean workroom).

iv)D) Unsterile supplies storage room (this may be located in

another department). E) Soiled or contaminated supply and equipment must be separated

from the clean or sterilized supply and equipment.

v)F) Cart storage areas.




B)G) Facilities for cleaning and sanitizing carts may be centralized or departmentalized.

C) Soiled or contaminated supplies and equipment shall be separated

from the clean or sterilized supplies and equipment. j) Obstetrics Suite. The number of delivery rooms, labor rooms, recovery beds, and the sizes of the

service areas shall depend upon the estimated obstetrical workload. The obstetrical suite shall be located and arranged to preclude unrelated traffic through the suite. The requirements of Part XV of the Act shall apply to this Section. 1) Delivery RoomsRoom(s). Each delivery room shall have a minimum clear area of 300 square feet

exclusive of fixed and movable cabinets and shelves. The minimum dimension shall be 15 feet15'-0" clear. The communications system shall be connected with the obstetrical suite control station. Separate resuscitation facilities (electrical outlets, oxygen, suction, and compressed air) shall be provided for newborn infants.

2) Labor RoomsRoom(s). These rooms shall be single or two-bed rooms with a minimum clear area

of 80 square feet per bed. Labor beds shall be provided at the rate of two for each delivery room. In facilities having only one delivery room, two labor rooms shall be provided, one of which shall be large enough to function as an emergency delivery room. Labor rooms shall be arranged so that they are accessible to a nurses'nurses work station, to facilities for medication, hand washinghandwashing, and charting, and storage for supplies and equipment.

3) Recovery Room. Recovery may take place in private or semiprivate patient rooms (if

separate recovery rooms are not provided). If a separate recovery room is provided, it may be part of an approved combined surgical-obstetrical program (see Section 250.1820(h)). Recovery rooms, if provided, shall must meet the following requirements: A) The postpartum recovery room shallshould be within or adjacent to

the obstetrics suite.




B) The recovery room shall have adequate lighting of the type to

allow accurate observation of the patients. C) AThere shall be a lavatory trimmed with valves operated without

the use of hands shall be provided. A clinical sink shall be made accessible.

D) A soiled holding area shall be available. E) Facilities for medical storage and preparation shall be provided. F) Adequate storage and work space within or adjacent to the

recovery room shall be available for necessary supplies and equipment.

G) Each bed site shall be adequately equipped with oxygen, suction

and at least one duplex electrical outlet. 4) Service Areas. Individual rooms shall be provided when required in this subsection

(j)(4)so noted; otherwise alcoves or other open spaces thatwhich will not interfere with traffic may be used. (Services may be shared with and organized as part of the surgical facilities if the approved narrative program reflects this sharing concept.) Service areas shall be arranged to avoid direct traffic between the operating and the delivery rooms. The following services shall be provided: A) Control station to permit surveillance of all traffic thatwhich enters

the obstetrics suite. B) Supervisor'sSupervisors office or station (may be part of control

station). C) Sterilizing facilitiesfacility(ies) with high speed

autoclavesautoclave(s) conveniently located to serve all delivery rooms. If adequate provisions have been made for the replacement of sterile instruments during delivery, sterilizing facilities in the delivery suite will not be required.




D) Drug distribution station. Provision shall be made for preparation

of medication to be administered to patients. E) Scrub facilities, which shall be conveniently located near each

delivery room, and shall be arranged to minimize any incidental splatter on nearby personnel or supply carts. Scrub sinksProvide scrub sink(s) thatwhich may be asepticallyasceptically operated without the use of hands shall be provided. (Wrist blades are not acceptable.)

F) Soiled workroom or a soiled room that is part of a system for the

collection and disposal of soiled materials. The soiled workroom shall contain a clinical sink or equivalent flushing rim fixture, a work surface, a sink equipped for hand washinghandwashing, a waste receptacle, and a linen receptacle. A soiled holding room shall be similar to the soiled workroom except that the clinical sink and work counter may be omitted.

G) Clean workroom or a clean supply room. A clean workroom is

required when clean materials are assembled within the obstetrical suite prior to use. A clean workroom shall contain a work surface, a sink equipped for hand washinghandwashing, and a space for clean and sterile supplies. A clean supply room shall be provided when a system issued for the storage and distribution of clean and sterile supplies does not require the use of a clean workroom.

H) Anesthesia storage facilities. Unless the official hospital

governing board action prohibits in writing the use of flammable anesthetics, a separate room shall be provided for storage of flammable gases in accordance with NFPA 99, Standard for Health Care Facilitiesthe requirements detailed in the National Fire Protection Association Standards 56A (Inhalation Anesthetics) and 56F (Nonflammable Medical Gases).

I) Anesthesia work area for cleaning, testing, and storing anesthesia

equipment, which. It shall contain a work counter and sink. J) Medical gas storage. Space for reserve storage of nitrous oxide




and oxygen cylinders shall be provided. K) Equipment storage areasarea(s) for equipment and supplies used in

the obstetrics suite. L) Staff clothing change areas. Appropriate areas shall be provided

for male and female personnel (orderlies, technicians, nurses, and doctors). These areas shall contain lockers, toilets, lavatories equipped for hand washing,handwashing and space for donning scrub suits and boots.

M) Stretcher storage area. This area shall be out of the direct line of

traffic. N) Janitors' closet. A closet containing a floor receptor or service sink

and storage space for housekeeping supplies and equipment shall be provided exclusively for the obstetrical suite.

k) Emergency Suite. Facilities for emergency care shall be provided in each hospital. The extent of the emergency services to be provided in the hospital will depend

upon community needs and availability of other organized programs for emergency services within the community. Hospitals having a minimum level of emergency services shall provide at least the facilities indicated in subsectionsItems (k)(1), and (k)(4) below, with back-up facilities within the hospital capable of furnishing the necessary support for servicesfacilities not provided in the emergency suite. Other hospitals shall provide as much of the following asthat is consistent with the services offered:. 1) An entrance sheltered from the weather with provision for ambulance and

pedestrian access. 2) A reception and control area conveniently located near the entrance,

waiting areasarea(s) and treatment roomsroom(s). 3) Public waiting space with access to toilet facilities, public telephone, and

drinking fountain. 4) A treatmentTreatment area. The Treatment area, which shall contain hand




washinghandwashing facilities trimmed with valves thatwhich are aseptically operated (i.e., knee or foot controls), general storage, medication storage, a work surface, medical X-rayx-ray film illuminators, and space for storage of emergency equipment such as defibrillators, cardiac monitors, and resuscitators (oxygen and suction may be portable).

5) A holding area adjacent to the treatment rooms. 6) A storage area out of the line of traffic for stretchers and wheelchairs. 7) Staff work and charting areas, which. This may be combined with the

reception and control areasarea or located within the treatment area. 8) Clean supply storage, which may be separate or located within the

treatment area. 9) Soiled workroom or area containing a clinical sink, work surface, and sink

equipped for hand washinghandwashing, waste receptacle, and linen receptacle.

10) ToiletProvide toilet facilities convenient to the treatment area.

l) Outpatient Department

1) An outpatientOutpatient department, if provided, should be located on an

easily accessible floor convenient to the radiology, pharmacy, and laboratory departments.

2) Facilities shall include, at a minimumRecommended facilities include:

A) Waiting room. B) Space for information, scheduling appointmentsappointment and

records. C) Medical social services. D) Examination rooms.




E) Dressing booths. F) Utility roomsroom(s). G) Storage room. H) Janitors' closet. I) Public toilets (accessible to the waiting room).

m) Service Departments

1) Dietary Facilities

A) General. Construction, equipment, and installation shall comply with thethe

standards specified in: The State of Illinois Rules (77 Ill. Adm. Code 750) for Food Service Sanitation Code. Food service facilities shall be designed and equipped to meet the requirements of the hospital. These may consist of an on-site conventional food preparing system, a convenience food service system, or an appropriate combination of the two.

B) Functional Elements. The following facilities shall be provided as required to implement

the type of food service selected: i) Control station forFor receiving food supplies. ii) Storage space adequate. Adequate to provide normal and

emergency supply needs, including food requiring cold storage and day storage.

iii) Food preparation facilities. Conventional food preparation

systems require space and equipment for preparing, cooking, and baking. Convenience food service systems such as frozen prepared meals, bulk packaged entrees, and individual packaged portions, or systems using contractual commissary service, require space and equipment for




thawing, portioning, heating, cooking, and/or baking. iv) Hand-washing facilitiesHandwashing facility(ies) located.

Located in the food preparation area. v) Patients' meal service facilities, e.g., facilities. Examples

are those required for tray assembly and distribution. vi) Dining space for. For ambulatory patients, staff and

visitors. vii) Ware-washingWarewashing space located. Located in a

room or an alcove separate from food preparation and serving areas. Commercial type dishwashing equipment shall be provided. Space shall also be provided for receiving, scraping, sorting, and stacking soiled tableware and for transferring clean tableware to the use areas. A hand-washinghandwashing lavatory shall be conveniently available.

viii) Pot-washingPotwashing facilities. ix) Storage areas for. For cans, carts, and mobile tray

conveyors. x) Waste storage facilities located. Located in a separate

room easily accessible to the outside for direct pickup or disposal.

xi) Toilets accessible to dietary staff. Hand-

washingHandwashing facilities shall be immediately available.

xii) Janitors' closet located. Located within the dietary

department, containing. It shall contain a floor receptor or service sink and storage space for housekeeping equipment and supplies.

xiii) Ice-makingIcemaking facilities.




xiv) AdequateProvide adequate can, cart and mobile tray

washing facilities as required. 2) Central Stores. The following, including storage spaces adequate to meet the needs of the

hospital, shall be provided: A) Unloading facilities. B) A receiving area. C) General storage rooms. These facilities shall have storage spaces adequate to meet the

needs of the hospital. D) Office space.

3) Linen Services.

A) On-site Processing. If linen is processed at the hospital site, the following shall be

provided: i) Soiled linen receiving, holding, and sorting room. ii) Laundry processing room. iii) Access to hand-washinghandwashing facilities. iv) Separate clean linen storage and issuing room or area. v) Clean linen inspection and mending room or area. vi) Storage for laundry supplies. vii) Janitors' closet containing a floor receptor or service sink

and storage space for housekeeping equipment and




supplies. viii) Cart storage. ix) Office space.

B) Off-site Processing. If linen is processed off the hospital site, the following shall be

provided: i) A soiled linen holding room. ii) Access to hand-washinghandwashing facilities. iii) A clean linen, receiving, inspection, and storage

roomrooms. iv) Cart storage. v) Office space.

4) Facilities for Cleaning and Sanitizing Carts. Facilities shall be provided to clean and sanitize carts serving the central

medical and surgical supply department, dietary facilities, and linen services. These may be centralized or departmentalized.

5) Employees'Employees Facilities. In addition to the employees' facilities such as locker rooms, lounges,

toilets, or shower facilities requiredcalled for in certain departments, a sufficient number of such facilities as required to accommodate the needs of all personnel and volunteers shall be provided.

6) Janitors' Closets. In addition to the janitors'Janitors' closets requiredcalled for in certain

departments, sufficient janitors' closets shall be provided throughout the hospitalfacility as required to maintain a clean and sanitary environment. Each shall contain a floor receptor or service sink and storage space for housekeeping equipment and supplies. SpacesSpace(s) for large housekeeping equipment and for back-up supplies may be located in other




areas. 7) Engineering Service and Equipment Areas. The following shall be provided:

A) RoomsRoom(s) or separate buildingsSeparate Building(s) for

boilers, mechanical equipment, and electrical equipmentBoilers, Mechanical Equipment, and Electrical Equipment.

B) Engineer's spaceSpace. C) Maintenance shopsShop(s). D) Storage room for building maintenance suppliesRoom for Building

Maintenance Supplies. E) Yard equipment storageEquipment Storage.

8) Waste Processing Services.

A) Storage and Disposal. Space and facilities shall be provided for the sanitary storage and

disposal of waste by incineration, mechanical destruction, compaction, containerization, removal, or by a combination of these techniques. Facilities for proper handling and disposal of infectious or radioactive waste substances shall be provided.

B) Incineration. If the hospital provides its own incineration:

i) The incinerator shall be in a separate room or placed

outdoors. ii) Design and construction of incinerators and trash chutes

shall be in accordance with NFPA Standard 82, Standard on Incinerators and Waste and Linen Handling Systems and Equipment.

iii) Incinerators shall be equipped to conform to requirements




prescribed by local air pollution requirementsregulations in the area.

9) Storage. In addition to the storage areas called for in certain departments of the

hospital, suitable additional storage shall be provided.

(Source: Amended at 35 Ill. Reg. ______, effective ____________) Section 250.2640 Details All details and finishes shall comply with the following:

a) Details 1) Compartmentation, exits, automatic extinguishing systems and other

details relating to fire prevention and fire protection shall comply with requirements listed in the appropriate sections of the NFPA Standard 101, Life Safety Code, 1976 Edition, for existing hospitals (for exception, see Subparagraph 2, of this Section).

2) Aisles, corridors, and interior ramps required for exit access from patient

sleeping areas shall have a minimum clear width of 7 feet7'-0"; any such aisles, corridors, and interior ramps located in other patient use areas shall have a minimum clear width of 6 feet6'-0".

3) Doors to patient rooms shall not be lockable from inside the room. 4) Doors on all openings between corridors and rooms or spaces subject to

occupancy, except elevator doors, shall be swing type. Openings to showers, baths, patient toilets, and other small wet-type areas not subject to fire hazard are exempt from this requirement. Sliding doors with a break-and-swing feature are acceptable.

5) GlazingFor glazing of existing doors, sidelights, borrowed lights, and

interior windows shall comply with thesee the State of Illinois " Safety Glazing Materials Act."

6) Elevator shaft openings shall be class B 1½-hour-labeled fire doors or




shall meet the requirements of NFPA 101, Life Safety Code, for vertical shaft enclosureas approved by the Department.

7) Linen and refuse chutes shall meet or exceed the following requirements:

A) Service openings to chutes shall be kept locked if located in

corridors or passageways. They may be located in a room of construction having a fire-resistance of not less than one hour.

B) Service openings to chutes shall have approved self-closing class B

1½-hour-labeled fire doors. C) Chutes shall discharge directly into collection rooms separated

from incinerator, laundry, or other services. Separate collection rooms shall be provided for trash and for linen. The enclosure construction for such rooms shall have a fire resistance of not less than two hours, and the doors thereto shall be not less than class B 1½-hour-labeled fire doors. External discharge containers need not be enclosed.

D) Gravity chutes shall be vented through the roof with provisions for

continuous ventilation as well as for fire and smoke ventilation. Fire and smoke ventilating openings may be covered with single strength sheet glass.

E) See NFPA Standard 82, Standard on Incinerators and Waste and

Linen Handling Systems and Equipment(Incinerators and Rubbish Handling) for other requirements.

8) Grab bars shall be provided at all patients' toilets, showers, tubs, and sitz

baths. The bars shall have 1½-inch clearance to walls and shall be securely anchored.

9) Location and arrangement of hand-washinghandwashing facilities shall

permit their proper use and operation. ClearanceProvide clearance for blade-type operating handles shall be provided where required.

10) Mirrors shall not be installed at hand-washinghandwashing fixtures in

food preparation areas or in sensitive areas such as nurseries, clean and




sterile supplies, and scrub sinks. 11) Paper towel dispensers and waste receptacles or electric hand dryers shall

be provided at all hand-washinghandwashing facilities except scrub sinks. b) Elevators All hospitals having patients' facilities (such as bedrooms, dining rooms, or

recreation areas) or critical services (such as operating, delivery, diagnostic, or therapy) located on other than the main entrance floor shall have electric or electrohydraulic elevators. 1) Number of elevators.

A) At least one hospital-type elevator shall be installed where one to

59 patient beds are located on any floor other than the main entrance floor.

B) At least two hospital-type elevators shall be installed where 60 to

200 patient beds are located on floors other than the main entrance floor, or where the major inpatient services are located on a floor other than those containing patient beds. (Elevator service may be reduced for those floors thatwhich provide only partial inpatient services.)

C) At least three hospital-type elevators shall be installed where 201

to 350 patient beds are located on floors other than the main entrance floor, or where the major inpatient services are located on a floor other than those containing patient beds. (Elevator service may be reduced for those floors thatwhich provide only partial inpatient services.)

D) For hospitals with more than 350 beds, the number of elevators

provided shall be based on the hospital's program narrativewill be acceptable if adequate.

2) Cars and platforms. Cars of hospital-type elevators shall have dimensions

that will accommodate a patient bed and attendants and shall be at least 5 feet5'-0" by 7 feet7'-6". The car door shall have a clear opening of not less than 3 feet, 8 inches3'-8".




3) Leveling. Elevators shall be equipped with an automatic leveling device

of the two-way automatic maintaining type with an accuracy of +½ inch. 4) Written certification of the latest inspection shall be posted in the cab if

available. c) Provisions for Natural Disasters General requirements. An emergency radio communication system is desirable in

each hospitalfacility. If installed, this system shallshould be self-sufficient in time of emergency and shallshould also be linked with the available community system and state emergency medical network system, including connections with police, fire, and civil defense system.


Section 250.2650 Finishes

a) Cubicle and window curtains and draperies shall be noncombustible or rendered flame retardant and shall pass both the large and small scale tests of NFPA Standard 701, Standard Methods of Fire Tests for Flame Propagation of Textiles and Films., "Fire Tests for Flame-resistant Textiles and Films."

b) Floors in areas and rooms in which flammable anesthetic agents are stored or

administered to patients shall comply with NFPA 99, Standard for Health Care FacilitiesStandard 56A, "Inhalation Anesthetics.". Conductive flooring is not required in emergency treatment, operating, and delivery rooms provided that a written resolution is signed by the hospital governing board stating that no flammable anesthetic agents will be used in these areas, and provided that appropriate notices are permanently and conspicuously affixed to the wall in each such area and room.

c) Floor materials shall be easily cleanable and have wear resistance appropriate for

the location involved. Floors in areas used for food preparation or food assembly shall be water-resistant and grease-proof. Joints in tile and similar material in such areas shall be resistant to food acids. Floors in toilets, baths, janitor's closets and similar areas shall be water resistant. In all areas frequently subject to wet cleaning methods, floor materials shall not be physically affected by germicidal and cleaning solutions.




d) Wall bases in kitchens, operating and delivery rooms, soiled workrooms, and

other areas thatwhich are frequently subject to wet cleaning methods shall be tightly sealed to the wall and floor and constructed without surface voids that can harbor vermin.

e) All wall finishes shall be washable and, in the immediate area of plumbing

fixtures, shall be smooth and moisture resistant. Walls in surgery, delivery, kitchens, and in other spaces, subject to frequent cleaning shall be of suitable materials.

f) Floor and wall penetrations by pipes, ducts, and conduits shall be tightly sealed to

minimize entry of vermin, smoke, and fire. Joints of structural elements shall be similarly sealed.

g) Ceilings shall be cleanable, and those in sensitive areas such as surgical, delivery,

and nursery rooms shall be readily washable and without crevices that can retain dirt particles. These sensitive areas, along with the dietary and food preparation areas, shall have a finished ceiling covering all overhead ductwork. Finished ceilings may be omitted in mechanical and equipment spaces, shops, general storage areas, and similar spaces, unless required for fire-resistive purposes.


Section 250.2660 Mechanical

a) Any retrofit of existing heating, ventilating, or air conditioning systems for energy conservation purposes may meet any or all of the requirements of Section 250.2480 (Mechanical) in lieu of the parallel requirements of this Section.

b) Boiler feed pumps, return pumps, and circulating pumps shall be furnished in

duplicate, each of which has a capacity to carry the full load. Blow off valves, relief valves, nonreturn valves, injectors and fittings shall be provided to meet the requirements of the city and state codes and recommendations of the American Society of Mechanical EngineersA.S.M.E.

c) Air Conditioning, Heating and Ventilating Systems

1) The systems should be capable of providing the following temperatures




and humidities in the following areas:

Temperature Relative Humidity % Area Designation ºF ºC Min. Max.

Operating Room 70-76* 21-24* 50 60

Delivery Room 70-76* 21-24* 50 60

Recovery Room 75 24 50 60

Intensive Care Units 75-80* 24-27* 30 60

Nursing Units 75 24 30 60

Special Care Nusery Units 75-80* 24-27* 30 60

Other patient areas 75 24

*Variable range required 2) Ventilation Systems

A) Air handling systems shall conform to NFPA Standard No.90A,

Standard for Installation of Air Conditioning and Ventilating Systems(1989), "Installation of Air Conditioning and Ventilating Systems".

B) Outdoor intakes shallshould be located as far as practical but not

less than 15 feet from exhaust outlets of ventilation systems, combustion equipment stacks, medical-surgical vacuum systems, plumbing vent stacks, or from areas thatwhich may collect vehicular exhaust and other noxious fumes.

C) All ventilation air supplied to operating rooms, delivery rooms and

nurseries shallshould be delivered at or near the ceiling of the area served, and all exhaust air from the area shallshould be removed near the floor level. At least two exhaust outlets shallshould be used in all operating and delivery rooms.

D) All central ventilation or air conditioning systems shall be

equipped with filters having efficiencies no less than those specified in the following:




FILTER EFFICIENCIES FOR CENTRAL VENTILATION AND AIR CONDITIONING

SYSTEMS IN GENERAL HOSPITALS

Area Designation Filter Efficiencies

(percent)

Sensitive Areas* 50

Patient Care, Treatment, Diagnostic and Related Areas 50

Food Preparation Areas and Laundries 50

Administrative, Bulk Storage and Soiled Holding Areas 20

*Includes operating rooms, delivery rooms, nurseries, recovery rooms, and intensive care units.

E) The filter shall be located upstream of the air conditioning

equipment. If a prefilter is installed, it shall be located upstream of the air conditioning equipment. The main filter may be located before or after the equipment.

F) Access to filters for changing shall be provided outside of clean

areas unless approved otherwise by the Department. G) All filter efficiencies shall be average atmospheric dust spot

efficiencies tested in accordance with the ASHRAE Handbook of Fundamentals (1981).

H) Filter frames shall be durable and shall provide an airtight fit with

the enclosing duct work. All joints between filter segments and enclosing duct work shall be gasketed or sealed to provide a positive seal against air leakage.

I) A manometer shall be installed across each filter bed serving

central air systems. J) Ducts thatwhich penetrate construction intended for X-rayx-ray or

other ray protection shall maintain the effectiveness of the




protection. K) Fire and smoke dampers shall be constructed, located and installed

in accordance with the requirements of NFPA Standard No.90A, Standard for "Installation of Air Conditioning and Ventilating Systems". Exception: all systems, regardless of size, thatwhich serve more than one smoke or fire zone, shall be equipped with smoke detectors to shut down fans automatically as specified in Paragraph 4-3.1 of NFPA 90Athat Standard.

L) Laboratory hoods shall meet the following general requirements:

i) Thethe exhaust system shall be separate from the building

exhaust system;, and ii) Thethe exhaust duct system shall be of noncombustible

corrosion-resistant material consistent with the usage of the hood.

M) Laboratory hoods shall meet the following special requirements:

i) Each hood for the processing of infectious or radioactive

materials shall have an adequate face velocity, shall be connected to an independent exhaust system, shall be provided with filters with 99.97 percent efficiency (based on the DODDOP, diocytlphthalatedioctylphthalete, test method as described in DODDOP Penetration Test Method MIL STD No.282 (1976): Filter Units, Protective Clothing, Gas-Mask Components and Related Products: Performance Test Methods) in the exhaust system, and shall be designed and equipped to permit the safe removal, disposal and replacement of contaminated filters.

ii) Duct systems in which radioactive and strong oxidizing

agents are present shall be constructed of corrosion-resistant material consistent with usage for a minimum distance 10 feet from the hood and shall be equipped with wash-downwashdown facilities.




N) The hood and duct system for cooking equipment used in processes producing smoke or grease-laden vapors shall complybe in conformance with NFPA Standard No.96, Standard for Ventilation Control and Fire Protection of Commercial Cooking Operations.(1991), "Vapor Removal Cooking Equipment." That portion of the fire extinguishment system required for protection of the duct system may be omitted when all cooking equipment is served by listed grease extractors.

O) Other exhaust hoods in food preparation centers shall have an

adequate exhaust rate. P) Clean-outCleanout openings shall be provided to allow proper

cleaning of the duct system serving kitchen and food preparation areas.

Q) The ventilation system for anesthesia storage rooms shall conform

to the requirements of NFPA Standard No.99, Standard for Health Care Facilities, (1993), "Health Care Facilities Code," including the gravity option system.

R) Boiler rooms shall be provided with sufficient outdoor air to

maintain proper combustion rates for equipment. S) Rooms containing heat-producing equipment, such as boiler

rooms, heater rooms, food preparation centers, laundries, and sterilizer rooms, shall be ventilated.

T) For general pressure relationships and ventilation of certain

hospital areas, see Section 250.Table F.

(Source: Amended at 35 Ill. Reg. ______, effective ____________) Section 250.2670 Plumbing and Other Piping Systems

a) General All plumbing systems shall be installed in accordance with the requirements of

the Illinois State Plumbing Code,code (77 Ill. Adm. Code 890) except that the number of waterclosets, urinals, lavatories, bathtubs, showers, drinking fountains,




and other fixtures shall be as required by the hospital programs. b) Plumbing Fixtures

1) Plumbing fixtures shall be of nonabsorptive acid-resistant materials. 2) Hand-washingHandwashing lavatories used by medical and nursing staff

shall be trimmed with valves thatwhich can be operated without the use of hands where specifically required in Section 250.2630previous sections. A) When blade handles are used for this purpose the blade handles

shall not exceed 4½ inches in length, except that the handles on clinical sinks shall not be less than 6 inches in length.

B) The hand-washinghandwashing and scrub sinks, in surgery and

emergency treatment, nursery, and delivery unitsSurgery and Emergency Treatment, Nurseries, and Delivery shall be trimmed with valves thatwhich are asepticallyasceptically operated (i.e., knee or foot controls) without the use of hands. Wrist blades are not acceptable.

3) Shower bases and tubs shall be provided with nonslip surfaces for

standing patients. c) Water Supply Systems

1) Systems shall be designed to supply water at sufficient pressure to operate

all fixtures and equipment during maximum demand periods. 2) Bedpan-flushing devices shall be provided on each patient toilet unless a

clinical service sink is centrally located in each nursing unit. This requirement does not apply to psychiatric units.

3) Water distribution systems shall be arranged to provide hot water at each

hot water outlet at all times. Hot water temperature at shower, bathing, and hand-washinghandwashing facilities shall not exceed 110º F (43º C).

d) Hot Water Heaters and Tanks. Storage tanks shall be fabricated of corrosion-resistant metal or lined with non-




corrosive material. e) Drainage Systems

1) Drain lines from sinks in which acid wastes may be poured shall be

fabricated from acid-resistant material. 2) Floor drains shall not be installed in operating rooms. Flushing rim-type

drains may be installed in cystoscopic operating roomsCystoscopic Operating Rooms.

3) Building sewers shall discharge into a public sewersewerage system.

When a public sewer system is not available, sewage and liquid waste shall be collected, treated, and disposed of in a private sewage disposal system. The design, construction, maintenance, and operation of the system shall comply with the Department's Private Sewage Disposal Code (77 Ill. Adm. Code 905). or into other approved disposal system.

f) Medical Gas Service

Medical gas inlets and outlets shall be provided as identified in Table E. Oxygen and Vacuum

Oxygen and vacuum shall be provided where required. g) Service Outlets Service outlets for central housekeeping vacuum systems, if used, shall not be

located within operating rooms. h) Fire Extinguishing Systems.

1) All existing fire extinguishing systems shall be designed, installed and

maintained in accordance with NFPA 101, (Life Safety Code), NFPA 13, Standards for the Installation of (Sprinkler Systems) and NFPA 25, Standards for the Inspection, Testing and Maintenance of Water-Based Fire Protection Systems-13A, (Sprinkler Systems Maintenance).

2) All buildings more than two stories in height shall be provided with a

Class III, Type 1 inside standpipe system. Such standpipe systems shall conform to the requirements of NFPA 14, Standards for the Installation of Standpipe, Private Hydrants, and Hose Systems, (Standpipe and Hose




Systems).

(Source: Amended at 35 Ill. Reg. ______, effective ____________) Section 250.2680 Electrical Requirements

a) General All electrical materials shall comply with theavailable standards of Underwriters'

Laboratories, Inc., or equivalent. b) Switchboards and Power Panels. Circuit breakers or fusible switches that provide disconnecting means and

overcurrent protection for conductors connected to switchboards and panelboards shall be enclosed or guarded to provide a dead-front type of assembly. The main switchboard shall be accessible only to authorized persons. The switchboards shall be convenient for use, readily accessible for maintenance, clear of traffic lanes, and in a dry, ventilated space free of corrosive fumes or gases. Overload protective devices shall be suitable for operating properly in the ambient temperature conditions.

c) Panelboards. Panelboards serving lighting and appliance circuits shall be conveniently located. d) Lighting.

1) All spaces occupied by people, machinery, and equipment within

buildings and at, approaches to and exits from buildings shall have lighting.

2) Patients' rooms shall be equipped with general lighting and night lighting. 3) Operating and delivery rooms shall have general lighting in addition to

local lighting provided by special lighting units at the surgical and obstetrical tables.

e) Receptacles (Convenience Outlets).

1) Anesthetizing locations. Each operating and delivery room shall have

receptacles of the types described in NFPA 99, Standard for Health Care




Facilities.Standard 56A, "Inhalation Anesthetics." 2) Patients' rooms. Each patient room shall have duplex grounding type

receptacles. Nurseries shall have similar receptacles. 3) Corridors. Duplex receptacles for general use shall be installed

approximately 50 feet50'-0" apart in all corridors and within 25 feet25'-0" of the ends of corridors.

f) Equipment Installation in Special Areas.

1) Installation in anesthetizing locations. All electrical equipment and

devices, receptacles, wiring and conductive flooring shall comply with NFPA 99, Standard for Health Care Facilities,Standard 56A, "Inhalation Anesthetics," except that a static-type line isolation monitor will be permitted.

2) Special grounding system. In areas such as intensive care units and

special care nurseries, where a patient may be treated with an internal probe or catheter, the patient rooms'rooms ground systemssystem shall comply with the following: A) A patient ground point shall be provided within 10 feet10'-0" of

each bed. The patient ground is intended to assure that under normal conditions all electrically conductive surfaces of equipment and furnishings within reach of the patient will be at the same electrical potential plus or minus 10 millivolts differential. This requirement is not intended to apply to devices and utensils such as bedpans and other small portable nonelectrical devices.

B) One patient ground point may serve more than one patient, but one

patient shall not be served by more than one patient ground point. C) The grounding conductor connecting any receptacle serving a

patient and the patient ground point shall not exceed the equivalent resistance of 15 feet15'-0" of No. 12 American wire gauge (AWG) copper conductor.

D) Exposed metal building surfaces or utility piping within reach of




the patient or others who may touch the patienthim shall be grounded to the patient groundpoint or to a separately established room groundpoint.

E) A reference groundpoint shall be established in the electrical

supply panel. F) The patient groundpoint and the room groundpoint, where

separated, shall be interconnected by a continuous, insulated, copper conductor not smaller than No. 12 AWG, and similarly connected to the reference ground. The groundpoints or may be individually connected to the reference groundpoint provided that the ground conductor resistance does not exceed that of 15 feet15'-0" of No. 12 AWG copper conductor.

G) Receptacle ground terminals shall be connected to the patient

groundpoint or to the reference groundpoint provided that grounding conductor resistance to the reference groundpoint does not exceed that of 15 feet15'-0" of No. 12 AWG, copper conductor.

H) Grounding of all metallic raceways shall be assured by means of

grounding bushings on all conduit terminations at the panelboard and by means of an insulated, continuous, stranded, copper grounding conductor, not smaller than No. 12 AWG, extended from the grounding bus in the panelboard to the conduit grounding bushings.

I) Grounding of metallic switch and receptacle plates shall be

provided by means of the mounting-screw connections to the device mounting yokes.

g) Nurses' Calling System.

1) General. In general patient areas, each room shall be served by at least

one calling station and each bed shall be provided with a call button. Two call devices serving adjacent beds may be served by one calling station. Calls shall register with floor staff and shall actuate a visible signal in the corridor at the patients' door, and in all other appropriate areas. In multicorridor nursing units, additional visible signals shall be installed at




corridor intersections. 2) Patients' emergency. A nurses' call emergency station shall be provided

for patients' use at each patient's toilet, bath, sitz bath, and shower room. 3) Intensive care. In areas such as intensive care where patients are under

constant surveillance, the nurses' calling system may be limited to a bedside station that will actuate a signal that can be readily seen or heard by the nurse.

4) Nurses' emergency. A communications system thatwhich may be used by

nurses to summon assistance shall be provided in each operating, delivery, recovery, emergency treatment, and intensive care room, in nurseries, and in supervised nursing units for psychiatricmental patients.

h) Emergency Electric Service.

1) General. To provide electricity during an interruption of the normal

electric supply, an emergency source of electricity shall be provided and connected to certain circuits for lighting and power.

2) Sources. The source of this emergency electric service shall be as follows:

A) An emergency generating set when the normal service is supplied

by one or more central station transmission lines. B) An emergency generating set or a central station transmission line

when the normal electric supply is generated on the premises. 3) Emergency generating set. The required emergency generating set,

including the prime mover and generator, shall be located on the premises and shall be reserved exclusively for supplying the emergency electrical system. EXCEPTION: A system of prime movers thatwhich are ordinarily used to operate other equipment and alternately used to operate the emergency generatorsgenerator(s) will be permitted provided that the number and arrangement of the prime movers are such that when one of them is out of service (due to breakdown or for routine maintenance) the prime moversmover(s) can operate the required emergency generatorsgenerator(s), and provided that the connection time




requirements described in subsection (h)(4)(D)(i) of this Section are met. 4) Emergency electrical connections. Emergency electrical service shall be

provided to the distribution systems as follows: A) Circuits for the safety of patients and personnel.

i) Illumination of means of egress as required in NFPA

Standard 101, (Life Safety Code). ii) Illumination for exit signs and exit directional signs as

required in NFPA Standard 101, (Life Safety Code). iii) Alarm systems, including fire alarms activated at manual

stations, water flow alarm devices of sprinkler systemssystem if electrically operated, fire and smoke detecting systems, and alarms required for nonflammable medical gas systems.

iv) Paging or speaker systems if intended for communication

during emergency. Radio transceivers where installed for emergency use shall be capable of operating for at least one hour upon total failure of both normal and emergency power.

v) General illumination and at least one duplex receptacle in

the vicinity of the generator set. B) Circuits essential to care, treatment, and protection of patients.

i) Task illumination and necessary life support receptacles in

infant nurseries; medicine dispensing areas; cardiac catheterization laboratories; angiographic laboratories; labor, operating delivery, and recovery rooms; dialysis units; intensive care areas; emergency treatment rooms; and nurses' stations.

ii) Corridor duplex receptacles in patient areas.




iii) Nurses' calling system. iv) Blood bank refrigeration. v) Equipment necessary for maintaining telephone service. vi) Fire pump if installed.

C) Circuits thatwhich serve necessary equipment. The connection to

the following emergency electric services shall be delayed automatic except for heating, ventilation, and elevators which may be either delayed automatic or manual: i) Equipment for heating, operating, delivery, labor, recovery,

intensive care, nursery, and general patient rooms except that service for heating of general patient rooms will not be required under either of the following conditions: if the design temperature is higher than 20ºF (-7ºC) based on the Median of Extremes as shown in the ASHRAE Handbook of Fundamentals, or if the hospital is served by two or more electrical services supplied from separate generators or a utility distribution network having multiple power input sources and arranged to provide mechanical and electrical separation so that a fault between the hospital and the generating sources will not likely cause an interruption of the hospital service feeders.

ii) Elevator service that will reach every patient floor.

Throwover facilities shall be provided to allow temporary operation of any elevator for the release of persons who may be trapped between floors.

iii) Ventilation of unfenestrated operating and delivery rooms. iv) Central suction systems serving medical and surgical

functions. v) Equipment thatwhich must be kept in operation to prevent

damage to the building or its contents.




D) Details.

i) The emergency electrical system shall be so controlled that

after interruption of the normal electric power supply the generator is brought to full voltage and frequency. It must be connected within 10 seconds through one or more primary automatic transfer switches to emergency lighting systems; alarm systems; blood banks; nurses' calling systems; equipment necessary for maintaining telephone service; and task illumination and receptacles in operating, delivery, emergency, recovery, and cardiac catheterization rooms, intensive care nursing areas, nurseries, and other critical patient areas. All other lighting and equipment required to be connected to the emergency system shall either be connected through the above described primary automatic transfer switches or through other automatic or manual transfer switches.

ii) Receptacles connected to the emergency system shall be

distinctively marked. Storage battery-powered lights, provided to augment the emergency lighting or for continuity of lighting during the interim of transfer switching immediately following an interruption of the normal service supply, shall not be used as a substitute for the requirement of a generator. Where stored fuel is required for emergency generator operation, the storage capacity shall be sufficient for not less than 24-hour continuous operation.


ILLINOIS REGISTER 15127 10 DEPARTMENT OF PUBLIC ...

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